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Credentialing Specialist (WFH)
PayCompetitive
LocationOrlando/Florida
Employment typeFull-Time
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Job Description
- Req#: 24498
Employer Industry: Healthcare Equipment and Services
Why consider this job opportunity:
- Generous paid time off and paid holidays
- Bonus and incentive opportunities available
- Commission for Account Executives
- Comprehensive benefits package including medical, dental, vision, and life insurance
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
What to Expect (Job Responsibilities):
- Administer contracts, including a complete review of payer contract language, policies, and procedures
- Complete payer credentialing and re-credentialing applications based on payer specifications
- Communicate with various departments regarding contract changes and distribute reference guides as needed
- Maintain databases of contracts and credentialing information within shared drives
- Research and verify contract requirements and updates to ensure compliance with medical billing standards
What is Required (Qualifications):
- High school diploma or GED equivalent required
- Knowledge of healthcare contract language and ability to read and interpret credentialing requirements
- Minimum of five years of directly related experience in the medical industry working with HCPCS, CPT, and ICD-9 codes
- Valid driver's license in state of residence with a clean driving record (when applicable for the position)
- Ability to effectively communicate in English, both orally and in writing
How to Stand Out (Preferred Qualifications):
- Paralegal certificate preferred
- Bachelor's degree or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts preferred
- Lead/supervisory experience
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