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Payor Credentialing Specialist - Remote

Mount Carmel Health System
Columbus, OH Remote Full Time
POSTED ON 1/20/2025
AVAILABLE BEFORE 3/20/2025
Employment Type:
Full time
Shift:

Description:

Position Purpose:

  • Responsible for the efficient administration of credentialing/re-credentialing for large multi-specialty medical group and multiple hospital facilities. Coordinates the application and renewal of insurance credentialing and enrollment for multiple third-party payers. Maintains a variety of databases to support the credentialing and enrollment functions; acts as a liaison for providers, operations, revenue site operations, and professional billing for credentialing and enrollment processes. Provides dedicated support to the professional coding and billing teams.
  • Specialty: Medical Group and Hospital
  • Location: Remote – local to Columbus Area – multiple month onsite training and onsite quarterly meetings – no reimbursement for travel.
  • Hours of office: Monday- Friday flexible between 6:30am – 6:30pm

What You Will Do:

  • Coordinates the third-party payor credentialing and re-credentialing processes for Medical Group Providers, including problem investigation and resolution
  • Coordinates the facility privileging and re-privileging processes for Medical Group Providers, including but not limited to:
    • Facilitates information collection,
    • completes application forms,
    • coordinates submission of applications, and
    • supports necessary follow-up, problem investigation and resolution.

Minimum Qualifications:

  • Education: high school diploma or equivalent
  • Must possess a comprehensive knowledge in practice and medical management, as normally obtained through an associate degree in a related field, and 3-5 years of professional office experience, including 2 years of medical billing experience with an understanding of Medicare, Medicaid, Health Maintenance Organization and Commercial insurance plans.
  • Prior experience with third-party payor credentialing, enrollment, or facility privileging preferred.

Position Highlights and Benefits:

  • Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
  • Retirement savings account with employer match starting on day one.
  • Generous paid time off programs.
  • Employee recognition programs.
  • Tuition/professional development reimbursement.
  • Relocation assistance (geographic and position restrictions apply).
  • Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing.
  • Employee Referral Rewards program.
  • Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!
  • Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information:

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our four hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

Our Commitment to Diversity and Inclusion


Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

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