Credentialing Specialist (Potential to Work from Home)

Eye Consultants of Atlanta PC • Atlanta, GA

7d • Remote

About The Position

Under limited supervision, the Credentialing Specialist manages and monitors processes and procedures supporting credentialing, re-credentialing, expirables data management, and delegated credentialing contract processes. The role oversees credentialing functions, including application management and primary source verification, and ensures compliance with applicable accrediting and regulatory agencies. The position offers flexibility to work from home and work between 32 and 40 hours in a given week.

Requirements

• High school education.
• Excellent verbal and written communication skills.
• Efficiency and organizational skills.
• Administrative skills.
• Computer literacy and adaptability to new technology.

Nice To Haves

• Medical practice experience.
• Surgical practice experience.

Responsibilities

• Serve as the company liaison with third-party payors.
• Manage up-to-date information regarding fee schedules.
• Manage and update credentialing and clinic licensure policies and protocols.
• Ensure reports on provider credentialing status are up to date and accurate.
• Define and implement processes to ensure credentialing is completed and kept up to date in a timely manner.
• Manage the process of negotiating new insurance contracts.
• Ensure clinic information is accurate in third-party payor directories.
• Develop and implement seamless protocols for gathering credentialing data from healthcare providers.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED