Credentialing Specialist Job at Community Medical and Dental Care Inc
Community Medical and Dental Care is looking for an experienced and talented Credentialing Specialist to join our team. Our focus has always been to offer a full range of quality medical care, dental care, and mental health services to the underserved community. We accomplish this by employing outstanding healthcare professionals who are devoted to our mission.
Responsibilities:
- Maintain all provider files, including application, contract, current NY medical license, current DEA license, malpractice insurance, board certifications and other pertinent forms
- Perform credential verification and request information from appropriate data banks
- Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
- Complete credentialing applications to add providers to Medicaid, Medicare, and commercial payers
- Credential new providers and re-credential current providers with hospitals at which they hold staff privileges
- Create and maintain collaborating agreements between our mid-level and physician providers.
- Perform monthly Exclusions & Sanctions
- Maintain schedule for provider re-credentialing
- Work closely with the billing staff to identify and resolve any denials or authorization issues related to provider credentialing
- Develops credentialing policies and procedures
- Complete other credentialing projects as assigned
- Perform related duties
Requirements:
- 2+ years credentialing experience
- Certified Provider Credentialing Specialist (CPCS) preferred
- Knowledge of provider credentialing and its direct impact on the practice's revenue cycle
- Excellent computer skills including Excel, Word, and email use
- Detail oriented with excellent organizational skills
- Ability to analyze complex application problems and provide solutions
- Ability to work with multiple projects and deadlines
- Excellent communication skills
Salary/Benefits:
- Excellent salary
- Medical benefits
- Paid Time Off
- Growth and Professional Development opportunities
About Us
Community Medical and Dental Care, Inc., has been providing quality medical care to underserved population of Rockland County, NY and surrounding areas since 1993. With close to 60 providers on staff, we offer a variety of services included Adult Medicine, Pediatrics, Family Practice, Allergy, Dermatology, Endocrinology, Ophthalmology, Urology, Podiatry, Psychiatry and Behavioral Health counseling, Nutrition Counseling, Speech Therapy, Dentistry and Oral Surgery.
Community Medical and Dental Care is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regards to race, color, religion, sexual orientation, gender identity, national origin, age, protected veteran or disability status or genetic information.
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