Payer Credentialing Specialist
About The Position
Under general supervision of the Billing Supervisor, this full-time position manages the entire lifecycle of payer enrollment, credentialing, and re-enrollment of healthcare providers and facilities with Commercial and Governmental payers for Plumas District Hospital. Responsible for maintaining provider databases, ensuring accurate, timely submission of documentation to secure billing privileges and network participation. Maintains and updates facility enrollment list. PFS duties will include resolving claim denials, verifying insurance and performing billing related tasks to ensure timely and accurate reimbursement.
Requirements
- Minimum three (3) years’ experience in Patient Financial Services or payer credentialing.
- Strong understanding of healthcare regulations, insurance plans, and payer credentialing processes.
- Excellent organizational and time management skills.
- Strong attention to detail and analytical skills.
- Maintain confidentiality and adhere to regulatory guidelines.
- Collaborate with internal teams including provider credentialing and billing to streamline processes.
- Ability to work independently and perform critical work under deadlines effectively with supervisors and other staff.
- Ability to be flexible and function well in a fast-paced online environment.
Responsibilities
- Act as the primary point of contact for providers regarding health plan enrollment and inquiries.
- Stay updated on changes in health plan enrollment regulations and credentialing standards.
- Develops and maintains professional and technical skills to ensure ongoing competence.
- Develops and maintains written instruction for each health plan requirements for provider enrollment.
- Maintains provider roster list for enrollment and re-enrollment purposes.
Benefits
- Excellent Medical, Pharmacy, Dental, and Vision Plans
- Paid days for continuing education, bereavement, and jury duty
- Retirement Plans with 3% company contribution
- Voluntary Life Insurance and Long Term Disability
- Considerable Paid Time Off
- Inclusive and connected work environment
- Competitive Compensation
- Discounted memberships with Flight/American Medical Care Network
- Shift differentials paid for certain work shifts, including Holiday pay
- PDH is thrilled to provide our Child Care Center services to all families in our area. Our program is operational from 7:45am to 5:15pm, Monday through Friday, and is approved for children aged 0 to 5 years. After submitting your application, our Child Care Director will get in touch with you about your acceptance into the program. Once approved, we will start the enrollment process. PDH employees take priority on our waiting list. For any additional questions please contact our Child Care Center Director at 530-283-7165 or [email protected]
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
