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Manage the credentialing database in Morrissey by making the necessary changes to provider demographics. The Credentialing Coordinator I is responsible for processing initial credentialing and recredentialing applications for practitioners in accordance with the contracted health plans, regulatory bodies, and NCQA standards.
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Demonstrate a solid understanding of credentialing and NCQA guidelines around Credentialing and Provider Network. Verifying the accuracy of all submitted credentialing information, and for creating, or auditing accurate Primary Source Verification (PSV) files for delegated credentialing and maintain NCQA Credentialing/Recredentialing Accreditation.
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Responsibilities include provider data management, review of incoming provider applications, copying, filing, scanning, verification of credentials, correspondence, audit preparation and special projects as assigned.
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The Senior Director will provide\ strategic leadership to the HHC System Credentialing Verification Organization (CVO), Medical Staff Office (MSO) and Provider Enrollment teams (PE.
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Produces management reports regarding operations performance and/or provider credentialing status for internal management and external providers using the health system's verification services.
$47,476 - $75,012 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Eyecare-partners.com. This position is responsible for supervising all activities within the billing office including but not limited to: insurance verification, patient statements, submission of clean claims, collection of patient and insurance receivables, patient and operations communications, and any activities related to patient access and credentialing.
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Five (5) years of credentialing and privileging or provider enrollment experience in a hospital setting OR Seven (7) years of experience in a Credentials Verification Organization (CVO.
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One Federal Solution is hiring an Administrative Specialist to support our Federal Government client in the Personal Identity Verification (PIV) card credentialing office in the Philadelphia,PA area.
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Certification as a Certified Professional in Medical Services Management or Certified Provider Credentialing Specialist or Certified Professional in Healthcare Quality or the willingness to achieve one of these certifications is required within 2 years.
$62,657 - $105,000 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Conducts primary source verification for all credentialing and re-credentialing applications. Accurately enters all critical data elements of provider applications into the Credentialing system.
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All job offers are contingent upon successful completion of credentialing including background investigation, and compliance with the U.S. Government Form I-9, Employment Eligibility Verification.
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Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing.
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Conducts primary source verification for prospective providers and re-credentialing of active providers utilizing NCQA and other federal and state regulatory requirements. Resolves complex provider issues relating to credentialing, enrollment, privileging, billing and payers.
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Promptly meet payor requests for provider re-credentialing, revalidation, and re-verification. Work collaboratively with Revenue Cycle Director, Hospital Billing Manager, Professional Billing Manager, Hospital Billing Specialists, Professional Billing Specialists, Hospital Charge Entry Specialist, Financial Counselor, and Hospital and Professional Billing Representatives to identify and resolve provider credentialing issues that have potential to confound authorization or payment for patient services.
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The credentialing specialist will acquire primary source information necessary for DMC employment, as well as both initial and reappointment application or verification with all contracted health plans to ensure that all physician and non-physician provider requirements are met.
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provider credentialing verification jobs
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