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Job Summary:
Responsible for obtaining necessary information and documentation to enable the submission of third party payer applications and contracts. Performs the necessary follow-up to confirm physician provider numbers have been assigned by payers and are logged into the Morrisey credentialing system. Responsible for maintaining physician payer application records and training new staff on payer application process. Maintains good business relationships with payers to facilitate payer application process. The position serves as the coordinator for the payer application process for employed physicians and voluntary physicians as requested for all operating units and Care New England Medical Group.
Duties and Responsibilities:
Working in conjunction with the provider on-boarding team, responsible for coordinating, processing and maintaining initial payer application information and documentation for new/established/voluntary and CNEMG practitioners utilizing the Morrissey credentialing system.
Maintain and update CAQH database as necessary for processing applications and recertification of provider as required.
Develop and maintain relationships with key contacts with payers and internal departments (especially Medical Staff office and clinical departments).
Monitor payers for updates/modifications to their credentialing process and documentation; Communicate changes to appropriate staff.
On a daily basis, documents and resolves issues in a timely manner, consistent with established department standards.
Participate in task forces and/or other meetings as assigned and execute other responsibilities (including administrative assistant duties) as assigned.
Performs other job related duties as assigned or directed.
Requirements:
Associates degree preferred with one to three years of experience in secretarial functions, with at least one year of experience in dealing with physicians, hospitals and managed care organizations, or equivalent combination of education and experience.
Must have exceptional interpersonal skills, telephone etiquette, written communication skills.
Computer experience with Microsoft office products including Word and Excel are required.
Must have the ability to be persistent with application follow-up process, while maintaining positive working relationships with customers, clients and co-workers.
Ability to demonstrate a high level of organizational skills, specifically file maintenance and record keeping.
Experience in physician payer credentialing, physician practice management and physician billing procedures is preferred.
Care New England Health System (CNE) and its member institutionsButler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Centerare trusted organizations fueling the latest advances in medical research, attracting the nations top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.
Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.
EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status
Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.
Full Time
Social & Legal Services
$45k-57k (estimate)
09/12/2024
11/11/2024
carenewengland.org
EAST GREENWICH, RI
3,000 - 7,500
1996
NGO/NPO/NFP/Organization/Association
RONALD WEAVER
$1B - $3B
Social & Legal Services
CNE owns and operates a chain of hospitals that provides primary care and behavioral health services for individuals.
The job skills required for Payer Credentialing Specialist include Billing, Microsoft Office, Managed Care, Written Communication, Organizational Skills, Practice Management, etc. Having related job skills and expertise will give you an advantage when applying to be a Payer Credentialing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Payer Credentialing Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Payer Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Payer Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Payer Credentialing Specialist. You can explore the career advancement for a Payer Credentialing Specialist below and select your interested title to get hiring information.