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Contracting Credentialing Specialist

Plano, Texas | Contract To Hire

Post Date: 08/24/2017 Job ID: 4559 Industry: Admin

The Contracting & Credentialing Specialist has responsibilities in all aspects of contracting in the Billing Department. This includes, but is not limited to: pre-contracting research for potential contracts, submitting applications for contract reviews, reviewing contract terms and performing contract-compliance audits. This job purposes also includes quality checks to ensure Billing compliance standards are met.


Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Thoroughly track all forms of contract-related communication & documents
  • Research provider, hospital and insurance network relationships
  • Run Reimbursement Reports to determine levels of contract pursuit
  • Generate various Billing-specific reports for analyzation and dissemination throughout department
  • Maintain various Medicare licenses and ensure credentialing is performed as needed
  • Regular and timely attendance
  • Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations

  • Dependability: The employee can be depended upon to complete work in a timely, accurate, and thorough manner and is conscientious about assignments.
  • Being dependable also includes promptness, regular attendance and compliance with work/departmental policies, procedures and protocols.
  • Communication & Contact: The employee communicates effectively both verbally and in writing with superiors, peers, and individuals inside and outside the Company.
  • Relationship with Others & Attitude: The employee works effectively and relates well with others including superiors, peers, and individuals inside and outside the Company. The employee exhibits a professional manner in dealing with others and works, to maintain constructive working relationships.
  • Self-Motivation & Initiative: The employee asks questions concerning projects and assigned tasks. The employees volunteers to take on addition responsibilities to meet the needs of the department.

  • Must have excellent Microsoft Office Suites skills with a specific focus in Excel, as this position requires a high volume of detailed generation and formatting of reports performed in Excel
  • Ability to type a minimum of 50 wpm with no errors
  • Excellent written and verbal telephone skills to include proper grammar with a positive and friendly demeanor
  • Ability to relate and communicate with all levels of management
  • Ability to maintain a high degree of professionalism and integrity
  • Possess strong and effective customer service skills
  • Display excellent judgment at all time
  • Absolute attention to detail and follow-up
  • Must be a team player, be flexible, and be a good listener with a high level of patience
  • Ability to manage sensitive, confidential issues
  • Ability to work in a fast-paced deadline oriented environment
  • Ability to multi-task and properly prioritize workload
  • Possess strong organizational and time management skills

  • High School diploma or equivalent

  • One to two years of health insurance experience
  •   Knowledge of Medical Terminology

This is a full-time exempt position. Days and hours of work are Monday through Friday, 8: 00 a.m. to 5: 00 p.m. with frequent extended daily work-hours to include possible weekends as business needs demand.

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