St. Petersburg, USA
The Credentialing and Contracting Specialist will complete variable requirements to determine and gather information necessary to analyze and process Physican Insurance Contracts. Contractor Specialist will track and log all completed contracts, maintain client contract files and calendar all renewal dates. This position will support and assist with management, Billing Department with any contracting issues. This position will be responsible assisting with ensuring a timely, effective credentialing process for provider with insurances and hospitals.
- Assist in managing credentialing processes for multiple providers
- Establish professional relationship with Insurance contacts to ensure information is being updated correctly and in a timely manner
- Assist the Billing Department with resolution of demographic errors corrections/updates within the carriers
- Assist Account Managers with any outstanding/pending contract and credentialing related issues
- Completion of outstanding requirements to complete Credentialing Process (NPI, CAQH, Credentialing Applications, PECOS)
- Provide weekly status report on on-going projects
- Requests and oversees distribution of practitioner expirations such as state license, malpractice insurance, CDS certificates and DEA certificates to the facilities on at least a monthly basis
- Participating in special projects as assigned, specifically those directed at improving the quality and process of contract
- Reviewing clients contracts and ensuring all contracts fees are entered correctly into their system
- Experience with system provider contract system configuration, contract interpretation and provider reimbursement
- Scan and distribute contract offers, meeting updated drafts, and completed contract documents to department members and clients.
- Contract renewals - Maintain the tracking of contract renewal and expiration data and manage the contract expiration notification process by sending letters to the appropriate people
- Research and develop guidelines and standards for new provider agreements
- Negotiate contracts, prepares analysis, recommends strategies, researches problem issues and serves as a client representative
- Initiate contracting process
- Re-negotiate expired or outdated contracts
- Update and maintain client's Fee Schedule Matrix and profiles
- * 2-3 years experience in Physician Contracting and Credentialing
* Must have knowledge with Credentialing databases such as (CAQH, HCA , PECOS, etc)
* Must have knowledge with Commerical and government Insurance Carriers
- Intermediate computer skills and proficiency in MS Word, Excel and Outlook required
- Experience with credentialing software preferred
- Certified Provider Credentialing Specialist (CPCS) credentials a plus
Medenet has been in the medical software business for over 20 years, which has custom tailored within the industry with its own software and products of the highest quality for a medical billing service. Medenet has the expertise of prtactice management, revenue cycle management, managed care contract negotiations, management consulting services, and EMR software implementation services. Medenet Inc. as a company makes Physicians lives easier with a streamlined workflow and a paperless office environment so that there is more efficiency and accountability for patient care and lost revenue. With Medenets implementation of EMR it eliminates paper charts, dictation and transcription costs and gives the physician remote access to records from anywhere, anytime. Medenet is able to serve a wide range of clients and take pride in giving each one of them a personalized experience. In the Medical field of revenue cycle management, Medenet Inc is able to meet any demand, serve any size of operation, in any medical specialty and provide customized service based on client needs.
If you are looking for a challenging career that is rewarding and provides growth career opportunities then look no further. Apply today to join a great company who is a transformational leader in the healthcare industry, supports an adaptable, flexible, work-life balance environment and offers employee/family benefits (medical, dental, vision, life insurance, vacation, etc).
Role: Medical Credentialing and Contracting Specialist
Location: St. Petersburg,
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