Provider Credentialing Specialist II
About The Position
At ZoomCare, we are working hard to make healthcare easy. Our mission is to deliver innovative, high-quality, convenient healthcare when patients need it. We offer same-day, no-wait visits in urgent care, primary care, and specialty care and we’re expanding from our roots in the Pacific Northwest to new markets. We hope you will apply to become part of our dedicated, fast-moving team of superstars! ZoomCare is seeking a Credentialing Specialist II to join our team! The Credentialing Specialist II is responsible for providing support to the Credentialing Team and works to support the goals of the Billing Department. The Specialist II assists in performing all credentialing and recredentialing activities. This role ensures that all ZoomCare’s new and existing provider’s files are maintained and continually kept up to date.
Requirements
- High school diploma or GED equivalent, required.
- Prior experience in credentialing, provider licensing, or privileging.
- Prior experience in Medicare provider enrollment
- Advanced understanding of NCQA Standards.
- Advanced knowledge of provider licensing processes with regulatory agencies.
- Able to effectively communicate both verbally and in writing.
- Proficient in Adobe, Google Suite, Microsoft Office Suite, Slack or related software and an ability to quickly learn new technology systems.
Nice To Haves
- Bachelor’s degree in finance, accounting, business administration, or a related field, or an equivalent combination of education and experience, preferred.
Responsibilities
- Manage credentialing and re-credentialing activities to ensure all ZoomCare provider files, both new and existing, are accurate and up to date.
- Maintain credentialing files, ensuring all licenses and certificates are current and completed on time with thorough follow-up.
- Review provider credentialing applications, including new applicant credentialing, re-credentialing, and ongoing maintenance of credentials.
- Monitor, track, and report credentialing information on a daily, weekly, and monthly basis.
- Follow up with providers and insurance to ensure all credentialing applications are received, processed, and files are accurate and current.
- Enroll providers in Medicare using the Medicare Identity and Access System and PECOS.
- Deliver excellent customer service by communicating effectively with the team, solving problems, and organizing projects.
- Analyze data with strong attention to detail and accuracy, prioritizing tasks to work efficiently.
- Other duties as assigned.
Benefits
- Medical, Dental, Vision benefits
- 401K with employer match
- Paid Time Off, Paid Holidays, Paid Parental Leave, Sabbatical Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
