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Credentialing Specialist

Title: Credentialing Specialist                                   

 

Classification (FLSA): Exempt

Position type:  Full time     

Reports to: Director, Credentialing

 

Summary / Objective: 

QGenda is looking to hire a full-time Credentialing Specialist. The ideal candidate is hyper-organized, able to work at a quick pace, and has a passion for credentialing.

We are looking for an experienced candidate who is committed to the growth of the organization and dedicated to providing exceptional customer service. They must be a team player and open to working closely with the credentialing team to handle the credentialing and payer enrollment process from beginning to end.

 

Key Responsibilities:

  • Perform the administrative and technical duties necessary to complete the provider enrollment process.
  • Work directly with administrative contacts and customers which includes: performing regular updates and communicating clearly on the status of the enrollment process to customers and contacts as designated by the customer, or manager on a regular basis.
  • Provide superior customer service at all times to internal and external contacts including customers, providers, representatives, and other staff.
  • Help manages the onboarding process by working directly with providers to help facilitate the process of PSV and enrollment with insurance payers.
  • Manage the credentialing process from start to finish including obtaining applications from the payers, completing applications accurately, submitting applications timely per policy or within a reasonable time frame to avoid delays, complete regular follow up with the payers to ensure applications are being processed, and obtaining contracts once the credentialing process is completed.
  • Properly maintain files on each provider as required by the customer, items may include (CAQH, CV, certifications, licenses, malpractice files, hospital privileges, etc.)
  • Maintain accurate and proper records in the credentialing database
  • Work closely with the other team members to ensure that the enrollment is handled as quickly and professionally as possible.

 

Knowledge, Skills and Abilities:

  • 3+ years of payer enrollment experience
  • PESC, or CPCS certification preferred but not required
  • Superior customer service skills
  • Strong interpersonal skills – team player who is able to prioritize multiple responsibilities, manage a large workload within tight deadlines – works well under pressure and consistently meets deadlines, readily adapts to change and excels in a productivity-based environment
  • Strong communication skills verbal, and written
  • Ability to organize and prioritize work and manage multiple priorities
  • Excellent computer skills
  • Ability to problem-solve, research and analyze data quickly
  • High sense of urgency and likes to meet deadlines

 

Education / Professional Certifications or Licenses Required:

  • Bachelor’s degree from an accredited University

 

Work Environment / Physical demands:

Computer-based work environment.

Sitting and standing for extended periods

Lifting of 5 - 10 pounds.

Awards:

  • 2021 - Top 100 Software Companies (The Software Report)
  • 2021 - Best in KLAS
  • 2021 - GA Fast 40
  • 2020 - Deloitte Technology Fast 500
  • 2020 - AJC Best Places to Work
  • 2020 - Top 25 Software Sales Executives
  • 2020 - Atlanta CFO of the Year
  • 2019 - AJC Best Places to Work
  • 2018 - EY Entrepreneur of the Year
  • 2018 - Deloitte Technology Fast 500
  • 2018 - Glassdoor Top 50 CEO

Compensation & Perks:

  • Competitive Salary
  • Bonus Eligible
  • 401k Employer Match

Great Benefits & Culture:

  • Full Health and Dental (QGenda pays 100% of the individual premiums)
  • Employee-centric work culture
  • 3 "Flex Hours" per week
  • Relaxed vacation policy
  • Company outings
  • Costco membership
  • Casual dress
  • Opportunity to be part of a fast growing software company with hundreds of customers and thousands of users around the world.

Applicants must be currently authorized to work in the United States on a full-time basis.

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