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Credentialing Specialist Physician Billing (13409)

CULLMAN REGIONAL
Posted 24 days ago, valid for a month
Location

Cullman, AL, US

Salary

Competitive

Contract type

Full Time

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Sonic Summary

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  • The position at Cullman Regional Medical Center is for a full-time credentialing specialist responsible for maintaining accurate information for healthcare providers.
  • Candidates are required to have a minimum of 1 year of experience in healthcare credentialing, or a Certified Professional Credentialing Specialist (CPCS) certification in lieu of experience.
  • The role involves processing credentialing and re-credentialing in accordance with various standards and regulations, as well as ensuring provider enrollment with CAQH and PECOS.
  • Strong organizational and interpersonal skills are essential, along with advanced proficiency in Microsoft Outlook, Excel, and Word.
  • The salary for this position is not specified, but candidates should be prepared for a role that emphasizes patient safety and quality.

Job DetailsJob Location: Cullman Regional Medical Center - Cullman, AL 35056Position Type: Full TimeJob Shift: DayJob Category: Admin - Clerical Responsible for credentialing and maintaining high quality and accurate information for new and established healthcare providers in a timely manner per the Medical Staff policies and procedures. Process and maintain credentialing and re-credentialing in accordance with Medical Staff policy and procedure, Joint Commission standards, State and Federal Regulatory regulations. Identify and evaluate potential red flags and work in collaboration with practitioner to document the issue and physician response. Ensure provider enrollment and maintenance with CAQH and PECOS. Responsible for payor enrollment and re-enrollment to assure claim acceptance. Coordinate with Medical Staff credentialing to obtain information and avoid duplication of efforts. Demonstrates and encourages team behavior and exceptional patient/guest experiences. Upholds and promotes patient safety and quality. Fulfills duties of a Billing Specialist in accordance with provider and/or clinic assignment. Qualifications Education:       High school diploma required.  Associate's degree preferred.  Certified Professional Credentialing Specialist (CPCS) desirable. Experience:       Minimum 1 year in healthcare credentialing preferred or Certified Professional Credentialing Specialist required in lieu of experience.  3-5 years in healthcare/medical office preferred.  Advanced proficiency in Microsoft Outlook, Excel, and Word.  Experience with CPSI and Cerner preferred. Additional Skills / Abilities:       • Strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlessly with excellent attention to detail. • Very strong interpersonal skills and the ability to build relationships with physicians, staff, and board members. • Expert level written and verbal communication skills with ability to communicate clearly and concisely • Proven ability to handle confidential information with discretion, be adaptable to various competing demands, and demonstrate the highest level of customer/client service and response. • Capable and comfortable dealing with sensitive and confidential information with discretion and trust. • Able to work well under tight deadlines and respond to rapidly changing demands while providing efficient follow-up. • Able to work with minimal supervision and work well in both individual and group environments.




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