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Credentialing Specialist

Company: Practice Management of America Inc
Location: Smithtown
Posted on: November 18, 2022

Job Description:

IPA NY is one of the fastest growing and largest multi-specialty IPAs in the country with a membership of over 2,800 independent physicians. We are looking for motivated and enthusiastic individuals who can thrive in a fast-paced and high-volume environment with minimal supervision. IPA NY provides an opportunity to further your existing knowledge and experience into a flourishing successful career. If you are looking to join a positive work environment, look no further than IPA NY.
This is an ONSITE position. We have offices in Hawthorne, NY and Commack, NY with open positions in both locations. BENEFITS

  • Medical, Vision and Dental Insurance - available after 30 days of employment
  • Short Term and Long-Term Disability
  • Voluntary term life
  • 401-K
  • Paid sick days and vacation days
  • Paid holidays
  • $20.00 -$24.00/ hour based on experience

    RESPONSIBILITIES
    • Credentialing Specialist compiles, maintains, and verifies provider data and profiles
    • Credentialing Specialist accurately and efficiently completes provider enrollment and re-credentialing applications for all insurance plans
    • Credentialing Specialists works in both delegated and non-delegated payors, credentialing providers for participation
    • Credentialing Specialist professionally communicates with all providers and provider liaisons
    • Credentialing Specialist monitor and update all expiring licensure, boards, and professional certifications
    • Credentialing Specialist will audit Commercial and Medicaid plan directories for current and accurate provider information
    • Credentialing Specialists will have the ability to work in a fast-paced, high-volume environment with multiple deadlines
    • Credentialing Specialists will maintains confidentiality of provider data
    • Credentialing Specialist will perform other related duties as assigned by management
    • Credentialing Specialist present at Committee Meetings utilizing PowerPoint and Excel for membership approvalsQUALIFICATIONS
      • 2 years of credentialing and healthcare administration experience
      • Knowledge of commercial and government payors
      • Strong working knowledge of Symplr and Intellicred software programs
      • Ability to communicate effectively, both verbally and in writing
      • Strong organizational skills
      • Strong experience and understanding of Microsoft Office (Excel, Word, PowerPoint and Outlook)
      • Working knowledge of CAQH, AMA, DEA, CMS, PECOS, OIG, ABMS, AOA, OPSED
      • Strong working knowledge of NCQA regulations and requirements
      • Ability to work independently with minimal supervision
      • Must be team player
      • Be familiar with NYS credentialing requirements

        Monday thru Friday
        830am-5pm
        40 hours a week



        PI195125812

Keywords: Practice Management of America Inc, Westport , Credentialing Specialist, Other , Smithtown, Connecticut

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