Credentialing Specialist

As industry-leading wound care providers, Healing Partners propel standard Skilled Nursing Facility wound care to a completely different level. Our multifaceted approach relieves various burdens – clinical, operational, financial, and practical – from busy owners, administrators, and employees, freeing each staff member to focus optimally on his or her responsibilities and improve overall facility management.

BENEFITS OF WORKING WITH HEALING PARTNERS:

• Competitive salary/rate
• Monday-Friday day schedule with on-call schedule
• Benefits: Medical, Dental, Vision, eligible on 1st day of month following start date
• Employee Assistance Program (EAP)
• Health Savings Account (HSA)
• Dependent Care FSA
• 401k, Short Term/Long Term disability and life insurance
• Tuition Reimbursement
• Discount Programs

Credentialing Specialist Job Responsibilities:

The Credentialing Specialist will assist in overseeing our physician and payer credentialing process. They will be responsible for their assigned state rosters, payer enrollments and credentialing at facilities where providers round. They report to the Credentialing Manager. 

• Maintains the credentials of new and existing physician and mid-level providers, their medical licenses, DEA certificates and managed care applications. 
• Responsible for entering in ongoing data and supporting documentation for all providers within the internal credentialing and CAQH databases to ensure all expirable/personal information updates are current and correct. 
• Provides credentialing information for new facilities and new provider information with facilities. 
• Responsible for all CAQH (re) attestation requests, new location entries, and updating annual professional liability insurance renewals. 
• Acts as liaison between practitioners and payers, identifies delays with payers, escalates and communicates delays or issues timely. 
• Builds knowledge base for payer requirements and forms. 
• Maintains credentialing and provider information databases. 
• Administers payer website access (government, third party insurance, third party websites) for new and existing business office staff. 
• Complete payer enrollments for ERAs and EFT and maintains database of payers enrolled. 
• Works with leadership to apply and maintain “in-network” status with insurance companies for practice(s) and providers, as well as maintains a current provider roster list with in-network providers. 
• Complete any other duties assigned by management. 

Credentialing Specialist Qualifications and Requirements:

• A minimum one year of relevant experience in credentialing, provider enrollment, or related field required.  
• Excellent interpersonal skills 
• Excellent communications skills both verbal and written. 
• Excellent organizational skills and an ability to manage follow-up efforts for multiple tasks. 
• Focused attention to detail to ensure accuracy and timeliness of credentialing information. 
• Ability to work under time constraints to meet deadlines. 
• Proficient use of Microsoft Office applications (Excel, in particular), internet resources and Adobe Acrobat. 
• Complying with HIPAA policies, Healing Partners Policies and federal/state laws 

Physical Requirements:

• This position requires long periods of time sitting or standing at computer, staring at screens, and speaking on the phone.

Work Environment:

• This position is remote and will need the employee to travel to area a few times a year for team events or training at the corporate office.

Job Type: Full-time

Salary: $58,686 – 70,000

Schedule:

• Day shift
• Monday to Friday

Work Location: Work Location

Healing Partners provides equal employment opportunities to all employees and applicants for employment without regard to race, color, ancestry, national origin, gender, sexual orientation, marital status, religion, age, disability, gender identity, results of genetic testing, or service in the military. Equal employment opportunity applies to all terms and conditions of employment, including hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.