Provider Data and Credentialing Specialist

Evergreen Health • Buffalo, NY

2d

About The Position

The Provider Data and Credentialing Specialist aids in maintaining data and documents for various licensed providers for the purpose of verifying credentials and completing payor credentialing / re-credentialing requests for billing. This role also provides administrative support to the Billing, Coding, and FCC teams, including ordering supplies and distributing incoming mail throughout the week.

Requirements

• Exceptional organizational and communication skills
• Excel in customer service, time management
• Demonstrate an awareness of and sensitivity to the issues and health disparities faced by underserved populations, including but not limited to individuals living with HIV, drug users, people of color, and others who are affected at a disproportionate rate
• High school diploma or equivalent
• Two (2) years of experience in either a clerical support, clinical administration, or insurance role

Nice To Haves

• EMR (electronic medical records) experience is a plus

Responsibilities

• Maintains provider data and documents using shared folders, spreadsheets, and credentialing software
• Creates and maintains credentialing tracking spreadsheets for the billing, medical and behavioral health teams
• Maintains CAQH profile accounts, including provider data, practice location information, licensing information and uploading documents when required
• Maintains individual NPI Registry accounts, including addresses, licenses, and taxonomy code information
• Creates and maintains practice agreements / collaborating agreements for mid-levels at the time of hire, and when updates are needed
• Submits new enrollment credentialing applications, demographic change forms, roster updates, directory attestations and termination requests as needed or as scheduled by payors

Benefits

• Multiple comprehensive medical health insurance plans for you to choose from
• Dental and Vision coverage at no cost to you
• Paid Time Off package that equals 4 weeks of time in your first year
• 403b with a generous company match
• Paid parking or monthly metro pass
• Professional development opportunities
• Paid lunch breaks

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees