Credentialing Enrollment Specialist

Jersey City, NJ

Posted: 10/24/2019 Job Number: 13327301

Job Description

Great opportunity available for several Credentialing Enrollment Specialist candidates for a company in Jersey City.

Essential Job Functions:
  • Thorough knowledge and proficiency in all aspects of provider enrollment in a professional healthcare practice setting.
  • Understanding of credentialing processes as it relates to medical billing including Electronic Remittances, Service Locations and other details that could impact reimbursement.
  • Primary source verification for resolves issues concerning provider's enrollment with insurance companies.
  • Ensures timely completion of credentialing and re-credentialing of providers for all insurance carriers.
  • Thorough knowledge and effectiveness in insurance portals including CAQH.
  • Obtains appropriate credentials as well as updated copies prior to the expiration date of any license, certification, or other required document.
  • Acts as liaison with Practitioners, billing management and insurance carriers.
  • Maintains internal files including copies of current credentials and load/scan all documents into credentialing database.
  • Maintain up to date and credentialing status in database. Generate routine reports in the database and sends to client.
  • Assists in all areas of Managed Care contracting, reimbursement/billing, and human resources/talent acquisition.Required Qualifications:
  • Bachelor Degree preferred or equivalent experience in business/healthcare environment.
  • 3+ years of applicable experience in credentialing in a professional practice. Multi-specialty experience is a big plus.
  • Excellent written and verbal communication skills with superior attention to detail.
  • Ability to multi-task under tight timelines with strong administrative and exceptional organizational skills.
  • Proficient in Microsoft Office Suite; Word, Excel, PowerPoint, Outlook calendaring and office scheduling and Internet navigation.
  • Advanced knowledge of Microsoft Excel and knowledge of credentialing databases or reporting systems.

Meet Your Recruiter

Elliot Kloper

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