Payor Credentialing & Compliance Specialist

Magruder Eye Institute; Orlando (FL); On-site; USD 48,000 - 60,000; Full time

Job summary

Ascend Vision Partners is seeking a Payor Credentialing Specialist to ensure accurate credentialing and compliance with payor requirements. You will manage credentialing processes, maintain documentation, and facilitate communication between providers and insurance companies.

You will handle applications, keep databases updated, and collaborate with internal teams to onboard new providers while staying updated on credentialing regulations.

Qualifications

• 2+ years of healthcare credentialing or payor enrollment experience.
• Strong understanding of credentialing processes and payor requirements.
• Excellent attention to detail and organizational skills.
• Ability to manage multiple tasks and meet deadlines.

Responsibilities

• Manage and process credentialing applications for healthcare providers with insurance payors.
• Verify and update provider information in credentialing databases and systems.
• Maintain compliance with state, federal, and organizational credentialing requirements.
• Communicate with insurance companies, providers, and internal staff to resolve credentialing issues.
• Track credentialing status and ensure timely completion of applications and renewals.
• Prepare and submit necessary documentation for initial credentialing and recredentialing processes.
• Conduct regular audits of credentialing files to ensure accuracy and completeness.
• Develop and maintain strong relationships with payors and external credentialing bodies.

Skills

Attention to detail

Organizational skills

Communication skills

Teamwork

Multitasking

Education

Associate or Bachelor's degree preferred

Tools

Credentialing software

Microsoft Office Suite

Job description

Ascend Vision Partners is seeking a Payor Credentialing Specialist to ensure accurate credentialing and compliance with payor requirements. You will manage credentialing processes, maintain documentation, and facilitate communication between providers and insurance companies.

You will handle applications, keep databases updated, and collaborate with internal teams to onboard new providers while staying updated on credentialing regulations.