Change Healthcare Credentialing Specialist in North Charleston, South Carolina
Overview of Position The Credentialing Specialist will be responsible for processing all tasks related to payor enrollment for entities and individual providers - including new credentialing, revalidations, demographic verifications, CAQH maintenance, internal database management and reporting. Responsible for processing credentialing and recredentialing applications and/or enrollments of health care providers, responsible for entering, updating, maintaining NPI and any other applicable provider numbers into the system. Reviews applications, prepares verification letters and maintains database. Contacts medical office staff, licensing agencies, and insurance carriers to complete credentialing and recredentialing applications.
What will be my duties and responsibilities in this job?
Complete the processes to credential physicians to meet payer criteria.
Enroll clients with participating insurances.
Input information to credentialing software in order to have most current data.
Maintain filing of all necessary credentialing documentation.
Follow up with clients and insurances in accordance with established guidelines for all credentialing assignments.
Communicate client issues with management at an early stage.
Be able to clearly and effectively communicate with physicians, physician staff, Operations Managers and
insurance companies handling basic questions dealing with the day-to-day operation of credentialing and
Have prompt response time to voice mail, email and other requests whether it is from supervisors, co-workers or
Have professional verbal and written communication skills.
Work well under difficult circumstances and tight time lines.
Know how to prioritize throughout the day as work flow changes.
Perform all other tasks as requested by senior management.
What are the requirements needed for this position?
Education / Training: Required: Undergraduate degree or equivalent work experience
1-3 years work experience
Minimum of 1 year credentialing experience
What other skills/experience would be helpful to have?
At least an intermediate proficiency of Office 365 products, especially Excel and Outlook.
Ability to communicate professionally (grammar and composition) with internal and external clients.
Forward-thinking and self-directed.
Able to read/listen to directions and follow them precisely.
Able to meet productivity standards outlined in department metrics.
What are the working conditions and physical requirements of this job?
Physical requirements include general office demands
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!
Equal Opportunity/Affirmative Action Statement
Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.
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Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.
Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.