pediatricsplus

Credentialing Administrator

Conway, Arkansas, United States

Sponsorship not specifiedDetected 26 days ago

LeadershipOrganizational Skills

About the role

This role is responsible for responsible for managing and maintaining provider credentialing with all contracted insurance carriers to ensure providers are properly enrolled and eligible for reimbursement.
The employee must frequently lift and/or move up to 50 pounds.

Maintain credentialing and recredentialing of all Therapy, Developmental Preschool, Management, and RISE team members.
Implement and utilize the HR database, including ways to improve efficiency by use of the database.
Compile and maintain current and accurate data for all providers in HCM and deTASO.
Maintain documentation and reporting regarding provider enrollments in process.
Maintain updated roster of providers for Professional Liability Insurance.
Maintain confidentiality of provider information.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Ability to read and interpret documents such as safety rules, policies, and other company documents.
Ability to maintain regular and punctual attendance.

While performing the duties of this job, the employee is frequently required to accurately communicate information and ideas so others will understand through sight and hearing.
The employee is regularly required to move including walking, running, jumping, and sitting.
The employee is regularly required to use hands and fingers to handle, lift, reach, and feel.
The employee is frequently required to stand and stoop, twist, bend, kneel, crouch, or crawl.
Ability to communicate effectively and professionally with a wide variety of people.
Computer skills which include a working knowledge of databases, word processing, spreadsheets, and internet software.
Ability to handle multiple tasks in a very busy environment.
Ability to write routine reports and correspondence.
Ability to effectively present information in one-on-one and small group situations.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.

15 Days of Paid Time Off
Medical, Dental, & Vision Insurance
Maintain and update Council for Affordable Quality Healthcare (CAQH) online credentialing application for all providers quarterly.
Maintain copies of malpractice coverage, current state licenses, and any other required credentialing documents for all providers.
Track license and certification expirations for all providers to ensure timely renewals and updates health plans accordingly.
Ensure practice addresses are current with health plans.
Update job knowledge by some or all of the following: participating in educational opportunities; reading professional publications; maintaining personal networks and/or participating in professional networks.

We are currently seeking a Credentialing Administrator to join our team of highly qualified professionals that share our mission of Empowering Children to Conquer their World!
The Credentialing Administrator will oversee the credentialing process from initial application through ongoing maintenance and recredentialing, ensuring compliance with payer requirements, all applicable laws and regulations, and organizational policies minimizing disruptions to billing and revenue cycle operations.

This listing is sourced directly from pediatricsplus's careers page and normalized into a canonical job model.