Senior Credentialing Specialist

Panorama Eyecare; Fort Collins (CO); Remote; Full time

Job summary

A leading healthcare organization is seeking a Senior Credentialing Specialist to manage all aspects of provider credentialing processes. This full-time position emphasizes attention to detail, organization, and great communication skills. Candidates with a strong background in medical credentialing and knowledge of HIPAA compliance will thrive in this role. Join Panorama Eyecare and shape the future of eyecare with our dedicated professionals.

Benefits

PTO Accruals Start at 3 Weeks

Comprehensive Medical and Dental Insurance

Company Paid Optical Allowance

Company Paid Routine Eye Care

Short Term and Long-Term Disability Insurances

Educational Allowance

Generous Paid Holiday Program

401K With Company Match

Qualifications

• 3+ years of medical provider credentialing experience required.
• Experience within HIPPA and compliance-sensitive environments preferred.
• Proficient use of Microsoft Office (Word, Excel, PowerPoint) essential.

Responsibilities

• Act as liaison between providers and credentialing vendor for enrollment.
• Coordinate credentialing committees and oversee processes.
• Maintain and verify provider licensing and accreditations.

Skills

Organizational skills

Attention to detail

Communication

Research and analysis

Customer service

Education

High school diploma or GED

Bachelor’s degree preferred

Tools

Microsoft Office

Job description

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Who We Are

At Panorama Eyecare, we are not just a team; we are a community of dedicated professionals united in our quest to provide the best eyecare anywhere. Our unflinching commitment to excellence and our core values are what make us an Employer of Choice. Join us in shaping the future of eyecare as we thrive together!

Description

Who We Are

At Panorama Eyecare, we are not just a team; we are a community of dedicated professionals united in our quest to provide the best eyecare anywhere. Our unflinching commitment to excellence and our core values are what make us an Employer of Choice. Join us in shaping the future of eyecare as we thrive together!

The Role

The preferred candidate will be extremely organized, able to work independently and conscientiously. The Credentialing Specialist will be accountable, in conjunction with Panorama’s outsourced credentialing vendor, for all aspects of the enrollment, credentialing, recredentialing, and the privileging processes for all medical providers who provide patient care. This person will oversee and work side-by-side with Panorama’s outsourced credentialing vendor, to ensure that all providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities. The Credentialing Specialist will be accountable for maintaining up-to-date data for each provider in Panorama’s outsourced vendor’s credentialing database and online systems and be held accountable for timely renewal of provider licenses and certifications. To be successful at this position, the successful candidate would need to be able to ensure accuracy, confidentiality, and prevalence of all information. The preferred candidate will have the ability to multitask several items and deadlines at once, be reliable and have exceptional people skills.

Essential Functions

To perform this job successfully, he or she must be able to perform each essential duty satisfactorily with a high level of skill and organization. Reasonable accommodations will be made to enable qualified individuals with disabilities to perform the essential functions.

• Acts as the credentialing liaison between providers and Panorama’s outsourced credentialing vendor for timely assistance with the enrollment, credentialing, and privileging processes.
• Works with practice location and surgery center managers, as well as with Panorama’s outsourced credentialing vendor to ensure that all providers are credentialed, enrolled, and privileged as appropriate.
• Coordinates credentialing committees with ASCs and oversees the credentialing process to completion to ensure all providers are current and maintained.
• Interfaces with internal and external customers on enrollment, credentialing, and privileging issues.
• Responsible for provider license and DEA renewals, as well as coordinating the renewal of provider board certification and lifesaving certificates.
• Maintains accurate provider information and affiliations with CAQH, PECOS, NPPES and CMS.
• Performs other job-related duties as assigned.
• Enrollment
• Engages with Panorama’s outsourced contract management vendor to confirm payor agreements and other payor contracting details
• Supports the entry of payer and practice location information in Panorama’s outsourced credentialing vendor’s credentialing system.
• Attaches payors to practice locations, as necessary.
• Confirms and reconciles, in coordination w/Panorama’s outsourced credentialing vendor, that all providers have appropriate practice locations loaded in practitioner data.
• Initiates credentialing vendor process for new providers to be added to group rosters with payors.
• Initiates requests for existing providers to add or remove practice locations with payors.
• Supports Panorama’s outsourced credentialing vendor with payor directory validation requests.
• Initiates requests to terminate providers with payors.
• Provides any e-mails/correspondence/communications received from payors to Panorama’s outsourced credentialing vendor.
• Supports Medicare and Medicaid Revalidation efforts.
  
  

Credentialing

• Confirms, reconciles, and maintains providers that should have privileges at ASC locations.
• Confirms which ASC location each provider has privileges for.
• Initiates Panorama’s outsourced credentialing vendor’s process for new providers to be privileged at ASC locations.
• Initiates Panorama’s outsourced credentialing vendor’s process for existing providers to practice at an additional ASC location.
• Coordinates package review with committee members.
• Completes approval of providers for ASC locations through committee module in vendor’s credentialing system, as needed.
• Maintains meeting minutes as documents of record for committee approval, as needed
• Maintains and confirms accuracy of reappointment dates.
• Maintains privileging forms
  
  

Privileging

• Confirms, reconciles and maintains lists of providers with outside privileges.
• Confirms, reconciles and maintains where providers have privileges.
• Submits requests for new providers requiring outside privileges.
• Provides any e-mails/correspondence/communications received communications received from facilities (privileging-related) to Panorama’s outsourced credentialing vendor.
• Assists in obtaining information from providers when unresponsive to Panorama’s outsourced credentialing vendor.
  
  

Requirements

Who You Are

Performance/Skills Requirements

• Must be extremely organized, methodical, and meticulous in your work product.
• Excellent attention to detail.
• Ability to research and analyze data.
• Ability to communicate effectively, both orally and in writing.
• Ability to manage a large volume in a fast-paced environment.
• Knowledge of medical credentialing and enrollment procedures and standards.
• Ability to work independently.
• Ability to use independent judgment to manage and impart confidential information.
• Ability to make administrative/procedural decisions and judgments.
• Ability to summarize complex issues into digestible summaries for presentation purposes.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• Ability to plan and prioritize daily, weekly, and monthly responsibilities.
• Must have strong self-discipline and motivation to work in a virtual environment.
• Experience within HIPPA and compliance-sensitive environments.
• Ability to convey a positive and professional image to patients and employees at all times.
• Proficient use of Microsoft office (Word, Excel, PowerPoint). Must be able to create tracking schedules and create simple grids in Excel for summary and presentation purposes.
  
  

Education & Experience Requirements

• High school diploma or GED required; bachelor’s degree preferred.
• Minimum of 3+ years of medical provider credentialing experience within a multiple practice (MSO) model environment.
• Working knowledge or experience with Symplr outsourced credentialing services a plus.
  
  

Additional Job Details

• This is a Full-Time, remote position for those who currently reside in one of the following states: CO, FL, KS, MA, MI, MO, NM, OR, PA, SC, VA, WY. Some travel may be required, as needed and/or necessary.
• Compensation for this role will be $26.15 - $31.15 an hour based on experience/certification.
  
  

Our Growth Opportunities

At Panorama Eyecare, we care about our employee’s ability to grow within the company. Therefore, we have created career growth plans that allow employees the ability to work toward their professional growth. We encourage all employees to apply for internal openings they may be qualified for, and we welcome the opportunity to interview and coach employees on how to grow.

Our Employee Perks

• PTO Accruals Start at 3 Weeks
• Comprehensive Medical and Dental Insurance
• Company Paid Optical Allowance
• Company Paid Routine Eye Care
• Short Term and Long-Term Disability Insurances
• Educational Allowance
• Generous Paid Holiday Program
• 401K With Company Match
  
  

Join Our Team!

Embark on a rewarding journey with Panorama Eyecare and become part of a team that embodies the values of Partnership, Engagement, Excellence, and Stewardship. As an Eyecare Professional, you will not only provide exceptional patient care, but also shape the future of our practices. Together, we are transforming the eyecare landscape. Our job postings are open for 30 days or until a qualified candidate is hired. Click "apply" now and let your passion for excellence and patient well-being shine!

EEOC

Panorama Eyecare is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any characteristic protected by law.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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