Provider Credentialing Specialist at Jobot
Armonk, NY 10504
About the Job
Provider Credentialing Specialist role with low-cost medical coverage, generous paid time off and 403B Retirement plan with company match
This Jobot Job is hosted by: Donna Gawroski-Kusik
Are you a fit? Easy Apply now by clicking the "Quick Apply" button and sending us your resume.
Salary: $60,000 - $65,000 per year
A bit about us:
A trailblazing fertility and family-building solutions medical benefits organization with over 25 years of success, has proudly supported over 500,000 families on the path to parenthood. To meet the evolving needs of today’s families, our organization is proud of our long-standing legacy in fertility and family well-being services, expanding offerings from pre-conception and fertility to parenting, healthy aging, and beyond. We have dramatically improved patient experience through a new and cutting-edge digital interface, customized to each patient’s journey, and expanded services designed to support the physical, emotional, and social health and happiness
We are the largest, most experienced fertility benefit management company in the country offering inclusive family-building solutions to employers, health plans and individual patients. From integrated fertility management, including medical treatment, pharmacy, and reproductive genetics, to surrogacy and adoption, our mission is to help build families by providing access to the best network of doctors, technology and emotional support at the lowest cost. Our programs include an integrated medical and pharmaceutical model that is unique to the industry. Its dedicated nurse care managers, all with experience in reproductive endocrinology clinics, guide employees through every step of their fertility journey, and are available 24/7.
Why join us?
Job Details
We are looking to hire a full-time Credentialing Specialist who will report directly to the VP of Network Development and Contracting.
As the Credentialing Specialist, you MUST have at least Two (2) years’ experience with Provider credentialing protocols, resources, process and regulatory requirements as well as two (2) years administrative experience supporting mid to high level management in a corporate environment and be able to utilize Microsoft Office Suite including: Word, Excel, PowerPoint, and Adobe Acrobat
In this rewarding role, you will be responsible for assuring that all provider credentialing is completed and maintained per company Policies & Procedures, state regulatory requirements, accreditation requirements and contracted health plan directives.
Assumes responsibility for licensure primary source verification for all UM team (physicians and nurses) per company policies & Procedures and maintains spreadsheet and documentation of PSV verifications
● Conduct initial Credentialing for onboarding Providers
● Prepare and maintain reports of credentialing activities for Provider’saccreditation,a liated insurancesauditsandemploymentstatus
● Screening practitioners applications and supporting documentation to ascertain their eligibility
● Able to establish and maintain active working relationships with MD Providers, Nurse Practitioners, Physician Assistants and RNs management, and contacts outside the organization
● Maintain necessary logs,lists,records, and current documentation required for provider credentialing and de-credentialing with the use of excel, and Outlook
● Maintains confidentiality and privacy of all Provider’s information
● Monitor and coordinate copies of current state licenses, DEA certificates,malpractice coverage and any other required credentialing documents for all providers with the use of state websites
● Maintain and coordinate Provider’s CAQH accounts
● Conduct initial enrollment is Provider's NPI number with the use of NPPES/CM Swebsite Patient Care Coordinator
Interested in hearing more? Easy Apply now by clicking the "Quick Apply" button.
This Jobot Job is hosted by: Donna Gawroski-Kusik
Are you a fit? Easy Apply now by clicking the "Quick Apply" button and sending us your resume.
Salary: $60,000 - $65,000 per year
A bit about us:
A trailblazing fertility and family-building solutions medical benefits organization with over 25 years of success, has proudly supported over 500,000 families on the path to parenthood. To meet the evolving needs of today’s families, our organization is proud of our long-standing legacy in fertility and family well-being services, expanding offerings from pre-conception and fertility to parenting, healthy aging, and beyond. We have dramatically improved patient experience through a new and cutting-edge digital interface, customized to each patient’s journey, and expanded services designed to support the physical, emotional, and social health and happiness
We are the largest, most experienced fertility benefit management company in the country offering inclusive family-building solutions to employers, health plans and individual patients. From integrated fertility management, including medical treatment, pharmacy, and reproductive genetics, to surrogacy and adoption, our mission is to help build families by providing access to the best network of doctors, technology and emotional support at the lowest cost. Our programs include an integrated medical and pharmaceutical model that is unique to the industry. Its dedicated nurse care managers, all with experience in reproductive endocrinology clinics, guide employees through every step of their fertility journey, and are available 24/7.
Why join us?
- Low-Cost Health insurance thru United Healthcare
- Critical Illness coverage
- Dental Coverage thru Guardian
- Vision Coverage thru Guardian
- 4 weeks paid vacation.
- 9 company paid holidays.
- Always off on your Birthday
- 401K Retirement plan with Company match
- 500K Basic Life insurance coverage
- Short term and long-term care coverage
- Flex spending account
- Health Savings Account
Job Details
We are looking to hire a full-time Credentialing Specialist who will report directly to the VP of Network Development and Contracting.
As the Credentialing Specialist, you MUST have at least Two (2) years’ experience with Provider credentialing protocols, resources, process and regulatory requirements as well as two (2) years administrative experience supporting mid to high level management in a corporate environment and be able to utilize Microsoft Office Suite including: Word, Excel, PowerPoint, and Adobe Acrobat
In this rewarding role, you will be responsible for assuring that all provider credentialing is completed and maintained per company Policies & Procedures, state regulatory requirements, accreditation requirements and contracted health plan directives.
Assumes responsibility for licensure primary source verification for all UM team (physicians and nurses) per company policies & Procedures and maintains spreadsheet and documentation of PSV verifications
● Conduct initial Credentialing for onboarding Providers
● Prepare and maintain reports of credentialing activities for Provider’saccreditation,a liated insurancesauditsandemploymentstatus
● Screening practitioners applications and supporting documentation to ascertain their eligibility
● Able to establish and maintain active working relationships with MD Providers, Nurse Practitioners, Physician Assistants and RNs management, and contacts outside the organization
● Maintain necessary logs,lists,records, and current documentation required for provider credentialing and de-credentialing with the use of excel, and Outlook
● Maintains confidentiality and privacy of all Provider’s information
● Monitor and coordinate copies of current state licenses, DEA certificates,malpractice coverage and any other required credentialing documents for all providers with the use of state websites
● Maintain and coordinate Provider’s CAQH accounts
● Conduct initial enrollment is Provider's NPI number with the use of NPPES/CM Swebsite Patient Care Coordinator
- Coordinates and executes all credentialing activities per company Policies & Procedures
- Ensure that Providers contacted receive prompt attention to their application and that credentialing protocols are followed in a timely manner
- Ensure that all Provider information is entered and maintained in company’s Provider Database
- Prepares and maintains credentialing files for review by internal staff or external clients
- Assist with credentialing audits as needed and directed by management
Interested in hearing more? Easy Apply now by clicking the "Quick Apply" button.
Salary
60,000 - 65,000 /year