• CREDENTIALING SPECIALIST

    Posted Date 1 month ago(1 month ago)
    Requisition ID
    2018-8813
    # of Openings
    1
    Department
    PATIENT FINANCIAL SERVICES
    Location Name
    Baptist Business Operations Center
    City
    Pensacola
    Category (Portal Searching)
    Patient Financial Services
    Position Type
    Full-Time
    Schedule
    Day Shift
  • Overview

    The Credentialing Specialist is responsible for preparing and submitting provider payer enrollment applications and supporting documentation for the purpose of enrolling individual practitioners and provider groups with appropriate commercial and governmental payers.   He/She updates and maintains the payer enrollment database and assists the Director in identifying the impact of pending payer enrollments to AR outcomes.  Works closely with the Physician onboarding department to communicate with providers the information necessary to complete payer enrollments.  Maintains an updated and accurate inventory of all providers status with payers and takes necessary steps to maintain current and accurate enrollments.

     

    The person in this position works under general supervision, is responsible for various shifts, may be subject to over 40 hours per week and/or callback as required, and may also be required to remain on campus immediately before, during, and after severe weather and/or disasters.

    Qualifications

    Requirements for Credentialing Specialist:

    • High school diploma or General Education Degree required
    • One year experience with physician (ambulatory) business office.
    • Six (6) months of payor enrollment experience preferred.
    • Must demonstrate knowledge of the following: Medical Terminology, Written communication skills, Verbal communication skills, Medicare regulations, Excel, WORD, Specific applications to use PC applications to achieve work goal Office applications: email, fax module, scan PDF, Fast paced work environment, Meeting deadlines, Organized, Time management, Conforming to standards, Phone customer service, Managing projects, Billing process, Audit Techniques, Healthcare financial regulations, Work well with other departments to achieve goal, Data entry, Works well within a team structure, Provider/payer enrollment techniques/guidelines, and Research.

    Requirements for Credentialing Specialist II:

     

    • High school diploma or General Education Degree required
    • Two years credentialing or privileging or healthcare related experience is required
    • CRCS-I or P or CHAA Certification is required 

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