Insurance Credentialer
California City, California, United States

Job Summary

Occupation Insurance Credentialer
Specialty All Specialties
Salary 45,000 – 60,000 yearly
Degree Required AAS/AAA Diploma/Certification
Position Type Full Time Part Time
Work Environment Hospital
Location North Las Vegas, Nevada, United States
Visa Sponsorship No

Job Description

Last Update: 11/05/24

Full-time Medical Office Insurance Credentialer Needed

Join our dynamic and innovative healthcare team at VitalCare Solutions in North Las Vegas, Nevada. We are a medical office committed to delivering exceptional patient care. With our state-of-the-art facilities and a dedicated team of professionals, we strive to provide a nurturing environment where employees can excel and grow in their careers. As an Insurance Credentialer, you will play a vital role in ensuring accurate insurance credentialing, enabling our organization to efficiently navigate the complex landscape of medical insurance.

Sign-On Bonus:

We offer a competitive sign-on bonus to attract top talent in the field of Medical Office Insurance Credentialing. Details will be discussed during the interview process.

Schedule:

Monday to Friday, 8am-5pm

Job Setting:

Outpatient medical office

Responsibilities:

  • Conducting thorough and accurate insurance credentialing and re-credentialing processes for healthcare providers, ensuring compliance with insurance carrier requirements.
  • Collaborating with physicians, office staff, and insurance companies to obtain necessary documentation and information for successful credentialing.
  • Verifying and updating provider information in credentialing databases and maintaining accurate records.
  • Monitoring and ensuring the timely renewal of provider credentials, licenses, and certifications.
  • Staying up-to-date with changing insurance regulations, policies, and procedures to ensure compliance and accurate billing practices.
  • Resolving any credentialing-related issues or discrepancies with insurance carriers, escalating complex matters as needed.
  • Coordinating with internal departments, such as billing and medical records, to ensure accurate and efficient claims processing.
  • Assisting with the preparation of reports and data analysis related to credentialing activities.

Qualifications:

  • Bachelor's degree in healthcare administration, business administration, or a related field.
  • Minimum of 2 years of experience in medical office insurance credentialing, preferably in a fast-paced healthcare setting.
  • Strong knowledge of insurance credentialing processes, including application completion, verification, and follow-up.
  • Familiarity with insurance plans, payer requirements, and relevant regulatory standards (e.g., CAQH, NCQA, Joint Commission).
  • Proficiency in using credentialing software and databases (e.g., Cactus, IntelliCred).
  • Excellent attention to detail, organizational skills, and the ability to manage multiple tasks simultaneously.
  • Strong analytical and problem-solving abilities to resolve credentialing issues effectively.
  • Exceptional communication and interpersonal skills to collaborate with various stakeholders and build positive relationships.
  • Professionalism, integrity, and a commitment to maintaining confidentiality.

Salary:

$45,000-$60,000 per year

Benefits:

  • Health, dental, and vision insurance plans
  • Retirement savings plan with employer match
  • Paid time off (vacation, sick leave, and holidays)
  • Continuing education opportunities
  • Employee assistance program (EAP)
  • Professional development and career advancement opportunities
  • Employee wellness programs

Join our team of dedicated professionals and make a significant impact on the healthcare industry by ensuring accurate insurance credentialing processes.

Apply with your CV today and take the next step towards a rewarding career.