Credentialing & Licensure Specialist

Company: Paradigm Oral Health
Location: Lincoln
Posted on: October 12, 2024

Job Description:

Role and Responsibilities The Credentialing & Licensure Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, and commercial payers. Roles and Responsibilities

• Maintains compliance with all regulatory and accrediting institutions.
• Manages individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
• Maintains CE hours to ensure compliance with state regulations.
• Applies for and renews all provider licenses.
• Completes revalidation requests issued by government payers.
• Completes credentialing applications to add providers to commercial payers and re-credentialing applications for commercial payers.
• Partners with Clear Choice to ensure credentialing of new providers and re-credentialing current providers.
• Maintains provider credentials with hospitals at which they hold staff privileges.
• Facilitates Integration of Acquisition and required processes.
• Works closely with the Revenue Cycle team to identify and resolve any denials or authorization issues related to provider credentialing.
• Performs other duties as assigned.Education and Experience
  • High School Diploma or equivalent required.
  • Associates degree in related field preferred.
  • Two or more years of relevant experience required.
  • Credentialing experience preferred. Skills and Abilities
    • Knowledge of provider credentialing.
    • Excellent computer skills including Excel, Word, and Internet use.
    • Detail oriented with above average organizational skills.
    • Excellent customer service skills.
    • Excellent written and verbal communication skills.
    • Ability to plan, prioritize, and meet deadlines.
      Core Benefits & WellnessMedical (including Virtual Care), Dental, and Vision CoverageEmployee Assistance Program (EAP)
      Financial Well-BeingCompetitive pay, Bonus potential, and annual merit reviews401(k) Plan w/Company MatchHealth Savings Account (HSA) with HDHP health plans
      Life InsuranceBasic and Supplemental Life InsuranceSpouse and Child Life Insurance
      Time Off, Disability And Leave Of AbsencePaid Vacation (Starting at 2 weeks) and 6 Annual Paid HolidaysLong and Short Term Disability Plans
      
      
      
      PI797c9f0b1945-37248-35773073

Keywords: Paradigm Oral Health, Omaha , Credentialing & Licensure Specialist, Other , Lincoln, Nebraska