Healthcare Credentialing Specialist

Healthcare Credentialing Specialist

Location: Lexington, Kentucky OR Louisville, Kentucky

Compensation and Benefits:

• Hourly Rate: $20 - $25 per hour
• Paid Time Off (PTO): 15 days annually, increasing to 20 days after 5 years of service
• Health Insurance: Medical, dental, and vision coverage
• Paid Leave Programs: Includes family, medical, and maternity/paternity leave
• Retirement Benefits: 401(K) matching and automatic profit-sharing plan
• Health and Wellness: Access to telemedicine, mental health support, and wellness program reimbursements
• Insurance Coverage: Life and disability insurance
• Work Flexibility: Hybrid/remote options available after completing the in-office training period

Position Overview:

We are looking for a detail-focused Healthcare Credentialing Specialist to join our Healthcare Consulting team. This role supports healthcare clients by managing their credentialing needs, ranging from individual practitioners to large medical groups. The role begins with in-office training, and upon completion, offers a flexible hybrid/remote work arrangement.

Primary Responsibilities:

• Submit and manage credentialing and revalidation applications for Medicare, Medicaid, and commercial insurance companies.
• Track the progress of applications, ensuring efficient communication with payers for timely enrollment.
• Resolve any credentialing-related challenges promptly and keep clients informed throughout the process.
• Handle payer contracts for new physician practices.
• Maintain and update provider licensure, certifications, insurance, and DEA records, utilizing systems like Intellisoft and CAQH.
• Stay updated on changing credentialing standards, conducting necessary research to ensure compliance.
• Provide regular enrollment updates to providers, practice managers, and billing teams to support timely claims processing.

Qualifications:

We are seeking candidates who thrive in a fast-paced environment with the ability to manage multiple tasks efficiently. A minimum of two years of credentialing experience is preferred, with emphasis on the following:

• Experience with multi-state credentialing processes and proficiency in the Intellisoft database.
• Background in setting up Electronic Funds Transfer (EFT) with a range of payers.
• Strong commitment to confidentiality, adhering to HIPAA standards.
• Excellent attention to detail and a proven ability to maintain accurate records.
• Self-starter capable of working independently and taking initiative on various projects.
• No specific educational requirements, but relevant credentialing experience is highly valued.

What We Offer:

We are dedicated to fostering a positive work experience, combining professional development with work-life balance. Our benefits are designed to provide you with comprehensive support, both at work and in your personal life. We offer the same excellent benefits package available to our Tax and Audit staff, with a focus on your long-term satisfaction and well-being.

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