Credentialing Specialist

Healthcare Outcomes Performance Company•Royal Palm Beach, FL

1d•Onsite

About The Position

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise. Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy. As Center for Bone & Joint Surgery of the Palm Beaches continues to grow, we are looking for a Credentialing Specialist. Please see below for the functions and requirements for this position.

Requirements

High school diploma/GED or equivalent working knowledge preferred.
3-4 years of Credentialing experience.
Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers.
Some knowledge of insurance billing and hospital credentialing a plus.
Knowledge of the credentialing process.
Knowledge of computer systems.
Knowledge of credentialing paperwork and timelines.
Knowledge of credentialing timelines and regulations.
Skill in establishing good working relationships with internal and external customers.
Skill in organizing daily work assignments for various providers.
Skill in managing multiple work assignments and set priorities.
Ability to establish good working relationships with internal and external customers.
Ability to communicate effectively with physicians, credentialing agencies and staff.
Ability to be organized and efficient in daily work activities/projects.

Nice To Haves

Some knowledge of insurance billing and hospital credentialing a plus.

Responsibilities

Reviews and completes hospital and payor applications for all health care providers.
Completes verification forms/letters for outside facilities.
Maintain billing insurance grid, provider insurance grid and each individual physician’s spreadsheet up to date on current insurance changes.
Track and maintain physician licensure(s), certification and CME credits.
Maintain practitioner credentialing files.
Maintain practitioner electronic file by keeping all applications/licensure current.
Maintains all renewal applications for both hospitals/insurances.
Has knowledge of Employee Handbook content along with established policies and procedures.
Relies on instructions and pre-established guidelines to perform the functions of the job.
Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.