Credentialing Specialist-Remote

QGenda

Location: Burlington, Vermont

Type: Full Time

Education: Bachelor's Degree

Experience: 3 - 5 Years

QGenda is a fast-growing Atlanta-based healthcare software company, with an amazing corporate culture, where we strive to be the best place to be a customer. Our software is used by thousands of hospital departments around the world to automatically generate the most optimized physician work schedules to accommodate complex business rules and accurately schedule the appropriate medical provider based on their skill level, specialty, availability, and preferences.

 

Role Overview: 

QGenda is looking to hire a full-time Credentialing Specialist. The ideal candidate is hyper-organized, able to work at a quick pace, and has a passion for credentialing.

We are looking for an experienced candidate who is committed to the growth of the organization and dedicated to providing exceptional customer service. They must be a team player and open to working closely with the credentialing team to handle the credentialing and payer enrollment process from beginning to end.

 

Responsibilities:

  • Perform the administrative and technical duties necessary to complete the provider enrollment process
  • Work directly with administrative contacts and customers which includes: performing regular updates and communicating clearly on the status of the enrollment process to customers and contacts as designated by the customer, or manager on a regular basis
  • Provide superior customer service at all times to internal and external contacts including customers, providers, representatives, and other staff
  • Help manages the onboarding process by working directly with providers to help facilitate the process of PSV and enrollment with insurance payers
  • Manage the credentialing process from start to finish including obtaining applications from the payers, completing applications accurately, submitting applications timely per policy or within a reasonable time frame to avoid delays, complete regular follow up with the payers to ensure applications are being processed, and obtaining contracts once the credentialing process is completed
  • Properly maintain files on each provider as required by the customer, items may include (CAQH, CV, certifications, licenses, malpractice files, hospital privileges, etc.)
  • Maintain accurate and proper records in the credentialing database
  • Work closely with the other team members to ensure that the enrollment is handled as quickly and professionally as possible

 

Skills and Qualifications:

  • 3+ years of payer enrollment experience
  • Superior customer service skills
  • Strong interpersonal skills – team player who is able to prioritize multiple responsibilities, manage a large workload within tight deadlines – works well under pressure and consistently meets deadlines, readily adapts to change and excels in a productivity-based environment
  • Strong communication skills verbal, and written
  • Ability to organize and prioritize work and manage multiple priorities
  • Excellent computer skills
  • Ability to problem-solve, research and analyze data quickly
  • High sense of urgency and likes to meet deadlines
  • Bachelor’s degree from an accredited college or university

 

Preferred Qualifications:

  • PESC, or CPCS certification

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