Credentialing Specialist

Description

Jewish Family Service Association of Cleveland is celebrating 150 years as a leading non-profit healthcare Agency with over 500 employees. Our Top Places to Work organization (14 consecutive years) has an immediate opening for a Part-Time Credentialing Specialist.

Must have a minimum of 2 years of experience in provider enrollment.

Part-Time, Hourly, (15 - 20 hours/week), Office-Based

Requirements

Job Summary: The Part-Time Credentialing Specialist processes all initial credentialing/re-credentialing applications for managed care plans, commercial plans, and government payers. This position is responsible for enrolling providers according to contracts for network participation. Assists with special projects or temporary assignments based on the operational needs of the department.

Duties and Responsibilities:

• Credentialing and privileging of new providers for in-network reimbursement rates with contracted insurance companies, maintaining provider enrollment rosters, managing CAQH, PECOS, PNM, and other enrollment portals.

• Revalidations as needed based on payer requirements

• Demonstrates awareness of, follows all safety policies and procedures, adheres to all recommended safe work practices, and contributes to the control of hazards in specified areas of responsibility.

• Performs other duties or special projects as required or as assigned.

Minimum Qualifications
Educational/Training Requirements:

• High School Diploma

Experience:

• 2 years credentialing experience; coverage-related issues preferred.

• Experienced in Microsoft Office (1 year minimum);
Excel, Word, and other applicable software.

Licenses/Certifications:

• Valid Ohio Driver's License

Knowledge,

Skills and Abilities

:

• Knowledge of medical insurance and coverage-related issues

• Excellent interpersonal skills

• Must be able to prioritize and schedule daily activities to ensure that all job requirements are met on an ongoing basis.

• Computer data entry experience.