Contracting Credentialing Specialist
Plano, Texas | Contract To Hire
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.
KEY ACCOUNTABILITIES/ESSENTIAL FUNCTIONS:
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.
SKILLS AND ABILITIES
- 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
REQUIRED EDUCATION AND EXPERIENCE
- High School diploma or equivalent
PREFERRED EDUCATION AND EXPERIENCE
- One to two years of health insurance experience
- Knowledge of Medical Terminology
POSITION TYPE/EXPECTED HOURS OF WORK
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.