- Full Time
- Mid Level
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.
- 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.
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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.