Healthcare Credentialing Specialist — Make an Impact

Health Point Family Care; Florence (KY); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Retention bonus

Scrubs provided

Tuition reimbursement

Paid holidays

Birthday off

Paid time off

Health/dental/vision

401K & life insurance

Job summary

HealthPoint Family Care Florence in Florence, KY is seeking a Credentialing Specialist to manage applications, renewals, revalidations and terminations with accuracy and timeliness. You will coordinate provider credentials and facility processes, maintaining files and ensuring enrollment with Medicare, Medicaid and private payers.

The role requires knowledge of credentialing systems, strong attention to detail and solid communication skills.

Qualifications

• One year of experience in direct credentialing, including Medicare/Medicaid and payer applications.
• Knowledge of Ohio and Kentucky Medicaid and Medicare credentialing requirements.
• Professional and detail oriented with strong communication skills.
• Intermediate MS Outlook, Word and Excel skills.
• Training in medical billing or a related field is a plus.
• Ability to maintain credentialing files and enrollment applications.

Responsibilities

• Track and complete credentialing applications, renewals, revalidations and terminations.
• Coordinate credential processes for practitioners and facilities in the organization.
• Maintain provider credentialing files, NPDB inquiries, and CAQH/NPPES databases; ensure timely enrollment applications.
• Credential providers with Medicare, Kentucky and Ohio Medicaid and private payers for multiple services.
• Track application status with timely follow-up to ensure enrollment.
• Process payer applications, initial and re-applications and attestations.
• Understand Medicare, Medicaid and commercial payor processes and EDI agreements.
• Maintain credentialing files (paper and electronic).
• Coordinate and participate in all phases of credentialing/re-credentialing profiles.
• Track credentialing status with networks.
• Review, update, maintain and report fee schedules for payors within the group.
• Support Revenue Cycle projects as assigned.

Skills

Attention to detail

Verbal and written communication

Credentialing experience

Education

High School diploma

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

HealthPoint Family Care Florence in Florence, KY is seeking a Credentialing Specialist to manage applications, renewals, revalidations and terminations with accuracy and timeliness. You will coordinate provider credentials and facility processes, maintaining files and ensuring enrollment with Medicare, Medicaid and private payers.

The role requires knowledge of credentialing systems, strong attention to detail and solid communication skills.