Credentialing Specialist, OneGI

Do you want to work for a company that values respect, integrity, accountability, and leadership? Are you interested in being a part of one of the nation’s leading providers of Gastroenterology care? If so, join us at One GI®, and become part of the family!

Who we are!

One GI®, a true collaboration of the very best clinical and business minds – which enables us to focus on what’s truly important – our patients. And your contribution will be integral!

What you will do:

• Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, and local regulations, guidelines, policies, and standards.
• Conduct primary source verification, collect, and validate documents to ensure accuracy of all credentialing elements; assess completeness of information and qualifications relative to credentialing standards.
• Identify, analyze, and resolve information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners; discover and convey problems to Credentialing Manager.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.
• Track license and certification expirations for all providers to ensure timely renewals and assists in submitting license and DEA registration renewal applications where desired.
• Assist in securing and maintaining enrollment with currently contracted plans as well as newly contracted plans upon identification.
• Assist in securing and maintaining facility affiliation where appropriate.
• Seek assistance from Payers regarding claims identified by the follow up team as having processed out of network.
• Thorough knowledge of compliance with state and federal laws, including HIPAA, required.

The generous benefits we offer!

• Excellent paid time off for a healthy work/life balance.
• We want to help you with your retirement, with our generous 401k plan. We will match 100% of the first 3% that you contribute, and 50% of the next 2% of your eligible contributions.
• Looking to further your education, we want to help! We offer education reimbursement, up to $10,000 per year (depending on employment status).
• Internal growth opportunities. We want to aide in your training and development.
• Competitive health and supplemental benefits; with fsa and hsa options.
• Know someone that would also bring value to our company, refer them to One GI® and get a $500 referral bonus!

What you bring:

• High School Diploma or equivalent required
• Minimum of two (2) years focused provider credentialing or provider enrollment experience.
• Working knowledge of Provider Enrollment portals including but not limited to CAQH, NPDB, Identity & Access Management, NPPES, PECOS, and Availity.
• Experience in performing primary data source verifications.
• Specific knowledge of provider credentialing and payer enrollment process
• Facility Credentialing/ Medical Staff Services experience, preferred.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Weekly schedule:

• Monday to Friday

Work Location: Hybrid