Credentialing Specialist - Part-time, Non-Exempt

Description

This position acts as liaison between Company’s clients and the payers, making sure that all accounts are set up correctly with payers so that claims process correctly. This department has a key role in onboarding new accounts, and its processes are critical to the success of all accounts.

Schedule/Availability
  • 20-25 hours per week
  • Available during reasonable daytime hours to answer staff questions
  • Enjoy flexible hours (but must be available during daytime business hours)
Responsibilities

Essential Functions:

  • Takes major lead in onboarding new accounts
    • Pays close attention to New Provider Onboarding tracker; accepts meetings with new clients to discuss their setups with payers
    • Ensures that credentialing, contracting and demographics work for new accounts is progressing in a timely manner
  • Becomes proficient in credentialing, contracting and demographics processes
    • Ensures that providers are credentialed in as efficient a manner as possible; improves protocols as needed
    • Works to facilitate effective communication with providers to obtain information needed for credentialing, contracting and demographics
    • Ensures that our process of performing demographics changes is as efficient as possible
    • Applies for new contracts as requested by providers; reviews existing contracts and suggests changes as needed
    • Attempts contract renegotiations for providers with existing contracts that are outdated or have poor fee schedules
    • Ensures that proper customer service is given to all accounts in a timely manner and that department tasks do not fall through the cracks; provides regular updates on work being performed
    • Protects provider-specific information including but not limited to date of birth, social security number, CAQH passwords and disclosure assessments in the strictest confidence
  • Utilizes Modio Health Software
    • Stays current with updates to Modio
    • Utilizes the software as much as possible to prevent human error and optimize efficiency/communication with payers
  • Effectively communicates with manager all concerns regarding workload and the ability to complete work
    • Asks for help when overwhelmed
    • Makes sure the schedule and assigned workload is reasonable
    • Informs manager when tasks fall behind by more than 5 days from department protocols, so that help can be assigned before the situation worsens
    • Is extremely transparent with the manager about all concerns so that issues can be addressed quickly
Skills
  • 2+ years’ experience contracting / credentialing with payers
  • Excellent written and verbal communication skills with the ability to effectively communicate and establish collaborative relationships with clients, LBS staff, and insurance companies
  • Experience with Modio software is preferred
  • PECOS experience
  • Experience with medical billing software, various EMR programs, and Microsoft Office products
  • Medical billing experience; knowledge of ICD-10, CPT, and HCPCS codes
  • High level of professional communication; written and verbal
  • Typing 60+ words per minute with high accuracy
  • High level of ethics and integrity in all areas
  • Able to prioritize work and meet deadlines
  • Able to establish relationships with multi-levels of staff appropriately
  • Flexibility to work in an extremely fast paced and dynamic environment
  • Ability to work independently and within a team
  • Strong organizational skills and attention to detail
Additional Information

Work Environment:

While performing the duties of this job, the employee regularly works in an employee provided in-home office setting. This role routinely uses standard office equipment such as computers, phones, printers, scanners and filing cabinets; all of which are provided by the employee.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to sit for long periods of time, use hands to finger, handle or feel; and reach with hands and arms.

Other Duties:

This job description is intended to convey information essential to understanding the scope of the job and the general nature and level of work performed by job holders within this position. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position. All positions at Larsen Billing Service are subject to duties as assigned by upper management, additional work hours as necessary, and subject to change.

Job Location
Remote work possible
Employment Type
Part-time
Date posted
January 13, 2023
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Position: Credentialing Specialist - Part-time, Non-Exempt

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