Credentialing Specialist (Potential to Work from Home)

Eye Consultants of Atlanta PC • Atlanta, GA

6d

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 contracts. The role oversees credentialing functions, including application management and primary source verification, and ensures compliance with applicable accrediting and regulatory agencies. The position is in the Finance department and is non-exempt. It offers flexibility to work from home and work 32 to 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

• Serves as the company liaison with third-party payors.
• Manages up-to-date information regarding fee schedules.
• Manages and updates credentialing and clinic licensure policies and protocols.
• Ensures reports on provider credentialing status are up to date and accurate.
• Defines and implements processes to ensure credentialing is completed and kept up to date in a timely manner.
• Manages the process of negotiating new insurance contracts.
• Ensures clinic information is accurate in third-party payor directories.
• Develops and implements seamless protocols for gathering credentialing data from health care providers.

What This Job Offers

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