Job Description

This is a remote position,  applicants must reside/legally authorized to work in the United States.

Est. Hourly Pay: $29.11 -$38.26

Job type: Full-time/Part-time

Location: Fully Remote

This position is responsible for meeting the requirements for credentialing as defined in our clients policies and procedures. Works closely with the Credentialing Supervisor in the credentialing process.

The Credentialing Specialist will be responsible for all aspects of the credentialing, recredentialing and privileging processes for all medical providers who provide patient care, clinics, and facilities. In this role, the Credentialing Specialist will be responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities and maintain up-to-date data for each provider in credentialing databases and online systems; including:

• Initial and reappointment of hospital privileges.


• Processing initial credentialing and re-credentialing applications

Primary - Essential Expectations for Success :

• Responsible for implementation and oversight of all activities related to payer enrollment for providers.


• Responsible for development of payer enrollment policies and procedures.


• Maintains knowledge of facility and payer credentialing requirements.


• Prepares reports from credentialing database and provides communication regarding credentialing status


• Coordinates and manages the dissemination to health plans and other payers.


• Other tasks / projects as assigned by leadership.

Primary Focused Work :

• PECOS/Medicare Enrollments


• Engage with Physician Clients


• Provider Licensing


• Preferred CPCS Certification


• Maintaining / Updating Provider Profiles CAQH/NPPES


• Facility Enrollment


• Multistate Payer Enrollment all Payers


• Trends / tracking and maintaining database

Skills Needed to Be Successful :

• Maintains compliance with regulations and laws applicable to job


• Professional level communication expectations with video, phone and email


• Ability to effectively prioritize the work to meet deadlines and expectations


• Meets the quality and productivity measures 


• Brings positive energy to the work


• Uses critical thinking skills


• Being present at work and reducing distractions


• Being a self-starter


• Incredible attention to detail

Core Talent Essentials :

• High School diploma or equivalent


• 2+ years previous experience in healthcare revenue cycle management


• Proven experience credentialing directly with Medicare, Medicaid, Commercial health plans and other private insurance companies to increase revenue


• Ability to work independently and within a team atmosphere


• Self-motivated and passionate about our mission and values of quality work


• Must have professional level skills in MS products such as Excel, Word, Power Point.


• Must be able to type proficiently and with an effective pace


• Proficient application of business/office standard processes and technical applications

Physical Environment:

• Prolonged periods of sitting at a desk and working from a computer


• Must be able to lift 15 pounds at one time


• Must be able to structure your home office to ensure patient information is secure, meeting the regulatory expectations

What’s in it for you?

• $2,000 Sign-On Bonus!


• UNCAPPED monthly commission!


• VERY generous ramp-up period with supplemental income!


• Full Benefits Package – Beginning on first day of employment!
  
  
  
  • Medical, Dental, Vision, and Life Insurance
  
  
  • Vacation, Sick Time, Personal days, and PAID Holidays
  
  
  • 401k eligible after 30 days with excellent company match
  
  


• Discounted services!

We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

We offer uncapped commission incentives, leaving earning opportunities limitless! If you're ready to embark on a rewarding journey with us and make a meaningful impact in the healthcare sector, we encourage you to apply!

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Alliance Service, Inc. (Healthcare staffing)

Job Tags

Hourly pay, Holiday work, Full time, Part time, Second job, Home office, Relocation bonus,

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