Credentialing and Enrollment Specialist
Denver, CO
Full Time
Experienced
$10,000 Sign on and $20,000 relocation offerings!
Must be able to relocate to Gillette, WY, On-Site Position
About:
Hoskinson Health & Wellness Clinic is a newly founded team-based physician-led, comprehensive health and wellness clinic in the beautiful area of Gillette, Wyoming. Our company was created to provide prospective healthcare resources to the community and meet the needs of our patient base.
Company Mission and Philosophy:
Hoskinson Health & Wellness Clinic is owned by physicians who have teamed together to help end discrepancies they have seen for decades in the healthcare space. Our mission is to help patients truly live better, healthier lives by providing comprehensive care through a variety of specialists and support services. HH&WC has an integrated regenerative & longevity philosophy that functions hand-in-hand with treatment planning, preventive care, and team collaboration on patient cases. We believe that patients are more than their diagnoses and deserve access to the best education and resources we can provide. To ensure this mission is met, we focus on integrating highly effective technology, encourage collaboration among the team, and take lower patient volumes to allow patients more time with our staff.
Position
As a Provider Enrollment & Credentialing Specialist, you will play a crucial role in ensuring that our organization's healthcare providers are properly enrolled and credentialed with insurance companies and regulatory bodies. You will be responsible for managing the entire enrollment and credentialing process, ensuring compliance with all relevant regulations and maintaining accurate documentation. Your attention to detail and ability to communicate effectively with internal and external stakeholders will be essential in this role.
Duties/ Responsibilities:
- Manage the provider enrollment and credentialing process from start to finish.
- Communicate with healthcare providers to collect necessary documentation for enrollment and credentialing.
- Complete and submit enrollment applications to insurance companies and regulatory bodies.
- Follow up on application status and troubleshoot any issues that may arise.
- Maintain accurate records of provider credentials, licenses, and certifications.
- Ensure compliance with all relevant regulations and accreditation standards.
- Collaborate with internal departments, such as billing and compliance, to facilitate the enrollment and credentialing process.
- Stay up-to-date on changes in enrollment and credentialing requirements.
- Provide reports and updates to management on enrollment and credentialing status.
- Assist with audits and accreditation surveys as needed.
- Manage the process of privileging providers at other entities.
- Obtain malpractice for all providers.
- Maintain and report on the status of each provider in the credentialing, enrollment and privileging process.
- Additional duties as assigned.
Education/Certifications/Licenses
- Bachelor's degree in healthcare administration, business administration, or a related field (Preferred).
- Certified Provider Credentialing Specialist (CPCS) certification or Certified Professional in Medical Services Management (CPMSM) certification from the National Association Medical Staff Services (NAMSS) (Preferred).
- Certified Provider Credentialing Specialist (Preferred)
- Experience in healthcare administration, credentialing, and privileging (Required).
- Experience in credentialing major payers such as Medicare, Medicaid, and others that we offer (Required).
Experience
- Credentialing Experience (5 years) (Required)
- Provider Enrollment (3 years) (Required)
- Hospital Credentialing (1 years)
- Administrative Skills 2 years (Required)
- Experienced working with insurance companies and regulatory bodies. 3-5 years
- Knowledge of healthcare laws and regulations related to provider enrollment and credentialing.
- Familiarity with enrollment and credentialing software systems preferred.
Required Skills/Abilities
- Excellent organizational skills and attention to detail.
- Strong communication and interpersonal skills.
- Ability to work independently and manage multiple priorities.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
- Problem-solving skills and ability to think critically.
- Knowledge of medical terminology and healthcare billing processes.
- Ability to maintain confidentiality of sensitive information.
- Adaptability to changes in regulations and requirements.
- Strong customer service orientation.
- Team player with a collaborative attitude
Benefits: We pay 100% of your medical, dental, and vision insurance provided by Cigna (low deductible plan) and Principal. You will be eligible to participate in our exceptional benefits program which coverage is effective on the first of the month following your date of hire. Additional benefits include tuition reimbursement, generous vacation and sick time accrual with carry-over and cash out options. There is an additional insurance provided by AFLAC that includes Short/Long Term Disability, Life insurance, Cancer, Critical Illness, Accident Insurance and other options. In addition, there is a $50.00 employer monthly allotment that is provided to select certain AFLAC coverages.
Retirement: No waiting period available to all employees. You can enter a percentage for Pretax, Roth, or both. We match 8% of your contributions. If your Pretax and Roth amounts combined exceed 8%, your additional contribution past 8% will go unmatched.NOTE:
The Clinic is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. The Clinic is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation to participate in the job application or interview process, contact Human Resources at 307-387-9850.
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