Contract - Payer Credentialing Specialist (Provider Enrollment)
- Washington
- $25.00 per hour
- Temporary
- Full-time
- Working closely with external payer credentialing vendor on notification of a provider's start, welcome packets, provider documentation and ensuring the provider is in all systems
- Researching and resolving billing vendor holds from insurance carriers forwarded to Sound Physicians by the external billing vendor using a variety of methods, dependent on the reasons
- Performing follow-up with Sound Physicians market locations as needed in order to research and resolve provider enrollment issues
- Performing follow-up with insurance payers via phone, email or website to resolve payer credentialing issues
- Managing the completion and submission of provider enrollment applications
- Performing tracking and follow-up to ensure provider numbers are established and linked to the appropriate Sound Physicians group entity in a timely manner
- Understanding specific application requirements for each payer including pre-requisites, forms required, form completion requirements, supporting documentation (DEA, CV, etc.) and regulations
- Maintaining documentation and reporting regarding provider enrollments in process
- Retaining records related to completed payer credentialing applications
- Working closely with program site management and Sound Physicians central services resources to expedite completion of forms and requirements including obtaining signatures, locating required documentation, etc.
- Establishing close working relationships with privileging coordinators, contracting department, medical management, and payer contacts
- Performing other duties and special projects as assigned
- Maintaining strict confidentiality with regard to protected health information and understanding and adhering to Sound Physicians HIPAA Privacy & Security policies and procedures
- Maintaining strict confidentiality regarding provider information
- Work Ethic – Dedication to getting the job done well and on time, regardless of circumstances, a can-do attitude
- Communication: The ability to speak, write, and listen clearly and consistently
- Relationship Building and Maintenance: The ability to create and nourish healthy, strong relationships, as the face of Sound
- Teamwork: Demonstrates the ability to pull people together into highly effective teams along with ability to work in a highly matrixed organization
- Critical Thinking: Demonstrates the ability to be proactive, anticipate needs; ability to make good decisions with incomplete, ambiguous information
- Adaptability – Demonstrates flexibility and a willingness to change as circumstances evolve and be coachable
- Resourceful – Proactive willingness to utilize available information and tools to figure things out, not afraid to ask questions when necessary
- Commitment – Demonstrates a dedication to the job, project, organization, customer/clients, and co-workers
- Self-Motivated: Proactively jumps in to start a task or project with limited direction; asks to take on more responsibility and what is next
- Customer-focused: Puts the customer's (internal and external) needs first and makes customers their top priority
- High School Diploma or GED required
- Expertise in Microsoft software products including Word, Excel, and Outlook
- 1 + years of Payer Credentialing experience required