Credentialing Specialist

Credentialing Specialist

At Anne Arundel Dermatology we give exceptional care - to our patients and to eachother.

Patient First | Caring | Accountability | Trust | One Team | Growth

Founded 50+ years ago with a mission to provide the highest quality and full spectrum of medical, surgical, and esthetic skin care services to each and every one of its patients, Anne Arundel Dermatology has assembled the finest group of dermatologists in the Mid-Atlantic and Southeastern states. With 280+ clinicians and 110+ locations in 7 states, we're thriving, growing, and looking to add talented individuals to our team!

The Credentialing Specialist coordinates and performs a variety of administrative duties that are required for credentialing, re-credentialing and enrollment of both the clinicians and office locations with Medicare, Medicaid and commercial insurance payers.

Responsibilities

• Maintain and perform a warm, friendly and welcoming relationship with all staff, all medical and non-medical professionals, vendors and visitors
• Prepare, submit and follow up on all initial payer applications for providers and office locations
• Prepare, submit and follow up on all re-credentialing applications for providers and office locations
• Contact and/or respond to requests for verification of credentials, current licenses etc. ensuring credentialing and licensing processes are completed timely and notifications are sent timely
• Prepare, submit and follow up on revalidation requests for providers and office locations.
• Review provider credentialing files and work with providers to obtain the necessary missing, incomplete and expiring items
• Track current status of applications, follow up as necessary and document activity in an accurate and timely manner
• Maintain and update provider files and rosters including but not limited to: internal provider and/or location roster lists, individual CAQH profiles, payer databases, NPI Database and Medicare and Medicaid databases and any other as needed
• Maintain consistent contact with providers to ensure that expectations are clear and requirements are completed in a timely manner
• Establish and maintain professional relationship with insurance providers, client contacts and credential personnel
• Ensure all PHI (Protected Health Information) remains confidential and is kept in a secure location at all times
• Complies with all health and safety regulations and requirements, departmental policies, procedures, and objectives
• Other duties assigned as deemed necessary by management.

Qualifications

• At least 2-3 years experience with provider enrollment
• Excellent Customer Service Skills, Interpersonal and Communication skills (both oral and written)
• Must have active listening skills and able to adapt to change
• Must be able to problem solve, strong sense of decision making and judgment, action oriented, approachable
• Must be able to organize, manage multiple projects at the same time
• Very strong knowledge and utilization in Microsoft Office, Word, and Excel
• Ability to maintain confidentiality and uphold the principles of compliance as outlined by the company
• Ability to work independently

Licensure/Certifications/Education

• High School Degree or Equivalent
• Experience with Credentialing software
• Experience working remotely preferred

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift 15 pounds at times.

The ideal candidate will have experience with Maryland and Virginia Payer enrollment.

This position is a Remote based position, with no more than 10% travel in the Support Center in Maryland.

Full time employees (defined as regularly working at least 30 hours per week) are eligible for the following benefits:

• Medical, Dental & Vision insurance effective 1st of the month after date of start
• Short-term and long-term disability, Voluntary life (employee, spouse, and child), Critical Illness, and Hospital Indemnity Effective the 1st of the month following date of hire
• Company provided Basic Life/AD&D insurance
• Paid time off
• Paid holidays
• Retirement Savings account
• Employee discount on cosmetic services and products