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Credentialing / Payor Enrollment Specialist

Company: OB Hospitalist Group
Location: Greenville
Posted on: August 13, 2019

Job Description:

Work with us. Use your skills and passion to make a difference in the lives of women and babies. As the nation's largest and only dedicated OB/GYN hospitalist provider, Ob Hospitalist Group ensures that every pregnant woman presenting to the hospital receives care from a highly skilled clinician team regardless of time, day or complication. We look to attract inspiring and motivated people who want to play a role in fulfilling our mission supporting our clinical team members from afar. Ob Hospitalist Group is great place to work, with opportunities to grow and develop as a valued and integral member of the team. Offering competitive compensation, generous Paid Time Off, health benefits and more. We welcome you to come join our team! Position Summary: Processes credentialing and re-credentialing applications and Credentialing Vendor requests for OBHG health care providers. Position Responsibilities: Essential

  • Maintain credentialing information by reviewing, entering and following up on missing
  • Establish and maintain professional relationship with providers, insurance providers, client contacts and account service/credential
  • Submit and follow up on request for signatures in a timely
  • Respond to credentialing
  • Contact and respond to request to/from hospitals, OSA and health payers for verification of provider's credentials, ensuring credentialing and licensing processes are completed
  • Responsible for the processing and preparation of the applications for insurance payer participation with the ability to manage multiple facilities'/payers' enrollment requirements; which includes non-application requests that are indicated by OBHG staff and/or facility/payer.
  • Track credentialing application
  • Maintains providers/practitioner files including maintenance of the OBHG provider database, individual CAQH profiles and providers rosters by identifying who may need updating or re-- credentialing and process
  • Maintains and updates CRM, Mail and Utility Logs for provider's licensure, board certifications and certificate
  • Escalate non-responsiveness of MD to Supervisor with documentation of
  • Meet required turnaround times and accuracy
  • Ensure all Protected Health Information is kept in a secure location at all times and maintain Compliance by communicating credentialing request, status and issues to the Corporate Compliance
  • Participate in the credentialing committee as
  • Perform other duties as assigned by Credentialing Supervisor and/or Management Essential Skills/Credentials/Experience/Education
    • Knowledge of clerical principles and strong telephone etiquette
    • Strong organizational skills and attention to
    • A minimum of a High School Diploma or equivalent is required; some college or equivalent experience is preferred. Preferred Skills/Credentials/Experience/Education
      • Two-three years of clerical
      • Strong computer skills, proficient in Word, Excel &
      • Preferred understanding of medical
      • CPCS credentialing Mental and Physical Demands (per ADA guidelines) Physical Demands:
        • Sitting for long periods of Occupation requires this activity more than 66% of the time (5.6+ hrs/day)

Keywords: OB Hospitalist Group, Greenville , Credentialing / Payor Enrollment Specialist, Other , Greenville, South Carolina

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