Job Detail
This job is no longer available.
Position: Medical Credentialing Specialist Category: Customer Service
City: Plano State : TX
Branch Name: Dallas/Richardson Dress Code: Business Casual
Branch Phone: (214) 217-6888 Job ID: 8558
Pay Information: $15.00 - $18.0000 Order Type: TE

Our client is a rapidly growing medical equipment manufacturer/supplier based in the Plano area and has experienced rapid growth over the last 24 months due to a recent acquisition and new customer wins. As a DME manufacturer/supplier, our client is seeking to add a Credentialing Specialist to their team.
The Credentialing Specialist will focus on credentialing managed care organizations and other federal insurance programs. In addition, the Credentialing Specialist will be the point person for initiating processes through these insurance companies.

  • Key deliverables will include:
  • Obtain and maintain all necessary documentation for credentialing and re-credentialing for national and state managed care organizations.
  • Proactively follow up with managed care plans and government agencies on submitted applications and provide written notification of provider terminations, location additions, and location deletions
  • Continuously inform supervisor on status and any delays to assist in managing expectations related to deliverables and deadlines
  • Complete credentialing and/or re-credentialing applications for governmental programs (Medicare and Medicaid) in an accurate and timely manner
  • Maintains knowledge of federal, state and local billing regulations
  • Informs management and compliance department of discrepancies
  • Works directly with the managed care organizations, insurance companies and agencies to proactively pursue reimbursement
  • Processes “release of information requests” consistent with HIPAA requirements

Our client is seeking a professional who possesses the following attributes:

  • 2+ years’ experience in a similar Medical Credentialing role
  • Strong attention to detail and quality
  • Proficient with Microsoft Office suite
  • Ability to learn multiple software applications
  • Understanding of HIPAA regulations and guidelines
  • Minimal typing skills of 35 words per minute
  • Ability to work with multiple computer screens

Education Required

  • High School diploma or equivalent

If you are looking for a place that is looking to hire "potential" vs. key words on a resume, then contact one of our recruiters immediatley at 214-217-6888 to discuss this opportunity.

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