Credentialing Specialist

BASS MEDICAL GROUP • Walnut Creek, CA

55d • Onsite

About The Position

The Credentialing Specialist is responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process for established providers and new providers joining the medical group. The Credentialing Specialist must be able to work independently with minimal oversite, think freely, and work in a fast paced, high volume work environment. The Credentialing Specialist must also be able to multitask and prioritize executing in a timely manner, be meticulous, have effective communication skills, and always want to learn more.

Requirements

• 2+ years of experience in credentialing and enrollments in various healthcare settings (physician office preferred).
• 2+ years in managing various insurance types: HMO, FQHC, PPO, IPA, Medicare PECOS, Medi-Cal PAVE.
• Medical billing experience preferred.
• Excellent customer service skills.
• Excellent written and verbal skills.
• Adaptability/Flexibility
• High diligence.
• Proficient Technical skills (including Microsoft Excel, Outlook, Word, Adobe PDF, & Internet)
• Works well with various software applications, such as CredStream, Cactus, and CredentialMyDoc.
• Works well as a team and independently.
• Positive “can do” attitude.
• Other duties as assigned.

Nice To Haves

• Medical billing experience preferred.

Responsibilities

• Collect credentialing and re-credentialing materials for providers.
• PECOS and PAVE enrollment, DME revalidation changes and Medicare Renewal Revalidations
• Submit enrollments for providers with various payors.
• Follow up on enrollment statuses with payors.
• Maintain credentialing database & CAQH.
• Renew expirables, such as licenses & certifications.
• Submit notifications for offboarding providers and location changes.
• Monitor & maintain credentialing email.
• Manage Payor Portal emails and access.
• Additional duties assigned by the supervisor.

Benefits

• Medical through Anthem Blue Cross PPO, Low-Cost Dental and Vision, Medical FSA & HSA.
• Basic Life & AD&D Insurance, Long Term Disability, 401K plan with an employer contribution, Access to Financial Advisors, Identity Theft Program.
• Paid Time Off and Company Paid holidays, Life Assistance Program, Commuter & Parking Benefits, Secure Travel Services, Healthy Rewards Program, Will Preparation Program, Additional perks to include discounts for Cellular phone and Gym memberships.
• Optional Life & AD&D Insurance, Aflac Supplemental Insurance, Pet Insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 501-1,000 employees