Credentialing Assistant

This position is responsible for entering, processing and maintaining the accuracy and integrity of the credentialing and re-credentialing of Providers in multi-states. Team members must maintain a working knowledge of requirements of Center of Medicaid/Medicare Services (“CMS”), Council for Affordable Quality Healthcare (CAQH), and 3rd party insurance requirements. This position maintains a high level of confidentiality, attention to detail, and professionalism in order to credential and prepare clinicians for billable services.
Responsibilities:

• Executes and processes credentialing and payor enrollment services for multi-states.
• Responsible for all Credentialing and provider enrollment processes related to compliance, regulations and billable services.
• Practices adherence to operating policies and procedures for Provider Credentialing.
• Understands and remains updated with current credentialing and payor enrollment related regulations and compliance requirements.
• Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
• Performs other miscellaneous job-related duties as assigned.

Qualifications:
Education

• High School Graduate required.
• Associates or Bachelor’s Degree preferred.

Experience

• Minimum of one to two (1-2) years of provider enrollment, payor contracting, billing or credentialing experience required.

Knowledge

• Team members must maintain a working knowledge of requirements for Center of Medicaid/Medicare Services (CMS), Council for Affordable Quality Healthcare (CAQH), and 3rd party insurance requirements.
• Working knowledge of HIPAA and medical terminology.
• Knowledge of multi- state credentialing requirements for various disciplines including Psychiatrist, Psychologist, Physician Assistant, Nurse Practitioner and other behavioral health professionals preferred.
• Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers.

Skills

• Skill in establishing and maintaining effective working relationships with other employees, doctors, facilities, insurance companies and regulators.
• Skill in adherence to and administering workflow processes in Credentialing and Provider Enrollment Services.
• Detail oriented and tolerant of frequent interruptions and distractions.
• Effectively communicate in writing and verbally with physicians, insurers, colleagues and staff.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.
• Ability to recognize, evaluate, solve problems and correct errors.
• Ability to work under minimum supervision and demonstrate strong initiative.
• Organized and ale to prioritize and schedule work assignments to meet practice timelines.
• Other duties as assigned.

Job Type: Full-time

Pay: $45,000.00 - $55,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• What is the best email to contact you?

Experience:

• credentialing: 1 year (Required)

Ability to Commute:

• Rockville Centre, NY 11570 (Required)

Work Location: In person

Salary : $45,000 - $55,000