MD EyeCare Services Corporate

Credentialing Specialist

US-TX-Dallas
2 weeks ago
Job ID
2017-1950
# of Openings
2
Category
EyeCare Services Partners
Type
Regular Full-Time

Overview

This is your opportunity to join one of the areas most recognized leaders in ophthalmology and optometry. We are a nationally recognized leader in EMR and technology with an excellent clinical support team and dynamic leadership.  We are committed to customer service, and making every interaction extraordinary while inspiring the complete confidence of our patients. Our employees contribute directly to the growth and success of our practices, and take pride in being a member of our team. We strongly believe that the manner in which our patients and customers are treated by our employees is as important as the services provided by the doctor.

 

The Credentialing Specialist is responsible for ensuring that all healthcare professionals' medical and employment files are complete prior to the start of their assignments. This position reports directly to the Credentialing Manager and works closely with Provider Recruiting. The Credentialing Specialist will actively process credentialing and re-credentialing applications of health care providers. 

Responsibilities

  • Execute the credentialing/re-credentialing process to ensure that they are conducted timely and in accordance to the ESP policies and procedures, health plan requirements and NCQA standards
  • Assist in reviewing and updating current credentialing policies, processes, procedures and reporting capabilities as needed
  • Ensure all required documents are maintained and current for all providers
  • Ensure maintenance of credentialing database with all appropriate information including Risk Management requirements
  • Responsible for the prompt and accurate resolution of escalated issues from providers and internal inquiries

 

Qualifications

The Credentialing Specialist Qualifications:

  • Bachelor’s Degree preferred
  • Certified Provider Credentialing Specialist preferred
  • At least five (5) years of experience in healthcare credentialing, medical billing follow-up, patient registration, charge entry, billing, and medical policies
  • Advanced knowledge of applicable credentialing and licensing requirements for physicians
  • Advanced knowledge of applicable state board of licensing applications for medical providers
  • Advanced knowledge of Medicare credentialing procedures and protocols for medical providers and ASC
  • Advanced knowledge of Medicare, Medicaid, BC/BS, Workers Compensation, Manage Care, and Commercial insurance carriers billing regulations

In Turn We Will Provide:

  • Benefits to full time team members that include comprehensive medical, dental and optical coverage, 401K and short and long term disability.
  • Company paid life insurance.
  • Paid holidays and generous paid time off.
  • Paid parking where applicable.
  • Team oriented working environment where you are heard and respected.
  • Clear career ladder opportunities.

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