Credentialing Specialists

Company Overview:
CareCloud is a leading provider of technology-enabled services and solutions that redefine the healthcare revenue cycle. We provide technology-enabled revenue cycle management and a full suite of proprietary cloud-based solutions to healthcare providers, from small practices to enterprise medical groups, hospitals, and health systems, throughout the United States. Healthcare organizations today operate in highly complex and regulated environments. Our suite of technology-enabled solutions helps our clients increase financial and operational performance, streamline clinical workflows, and improve the patient experience.

Job Summary:
CareCloud is looking for a highly skilled and experienced Credentialing Specialist to join our team in Rutherford, NJ. The successful candidate will collaborate closely with clients to ensure timely completion of credentialing tasks.

Essential Duties and Responsibilities:

• Receive and process all initial credentialing and re-credentialing applications.
• Complete enrollment applications for Medicare, Medicaid, and other programs.
• Communicate with physicians and clients to obtain necessary credentialing documents.
• Ensure all physician credentials are current and legible.
• Manage the collection of data related to provider credentialing, re-credentialing, and contracting. Maintain provider files in the credentialing/contract system as needed.
• Ensure the credentialing process adheres to industry and company standards.
• Maintain accurate and complete records on application status for presentation to management and clients.
• Perform monthly and/or quarterly compliance verifications.
• Demonstrate knowledge of CAQH, PECOS, and NPPES.
• Process approval, denial, or termination letters.
• Maintain a strict level of confidentiality.
• Perform other duties as assigned by the Manager.

Required Knowledge, Skills, and Abilities:

• Knowledge of CAQH, PECOS, NPPES
• High School Diploma or Equivalent
• Knowledge of Excel and Word
• Excellent written and verbal communication skills
• Ability to be flexible, multi-task and prioritize
• Demonstrated ability to plan and organize projects with attention to detail
• Ability to work collaboratively with multiple health professionals using tact, diplomacy, and discipline
• Ability to handle a high volume of providers and locations
• Familiar with credentialing and re-credentialing for multiple states

Education and Experience:

• High school diploma or equivalent preferred
• 2 years of related credentialing experience in a related business sector preferred

SupervisoryResponsibilities:
None.

TravelRequired:
Minimal.

PhysicalRequirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.

EEO Statement: CareCloud is committed to equal employment opportunity for all qualified individuals. We are committed to complying with all federal, state, and local laws providing equal employment opportunities,and all other employment laws and regulations. CareCloud prohibits discrimination against employees and applicants because of race, religion, color, gender (including gender or sexual identity or expression), age, national origin, ancestry, marital status, sexual orientation, physical or mental disability, medical condition including genetic characteristics, genetic information, veteran status, or other characteristics protected by applicable law.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. This position requires the ability to occasionally lift office products, equipment, and supplies, up to 20 pounds.

ADA Statement: CareCloud is fully compliant with the ADA and will provide reasonable accommodations to enable individuals with disabilities to perform essential job functions under the guidance of the ADA.

Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that you may be asked by your managers to perform other duties.

Benefits:
CareCloud recognizes the importance of benefits and wellness for employees and their families. In addition to time off to support work-life balance and enjoyment, we offer a comprehensive benefits package designed for employees’ individual needs (including domestic partners).

• Healthcare – A choice of medical plans designed to meet your individual needs
• Dental & Vision
• 401(K) with company match
• Flexible spending accounts (health & dependent care)
• Company-paid life insurance (accidental and supplemental coverage at low cost)
• Company-paid Short and Long term disability
• Voluntary benefits
• Flexible PTO and Paid Holidays