IPractice Healthcare Business Solutions is looking for a Full-Time Hybrid Credentialing Specialist that ensures providers maintain active status with hospitals, government and private payer programs. The Coordinator will also be the primary person interacting with clients, on-boarding new providers and providing updates. Previous experience with new provider enrollment or medical staff enrollment required. Familiarity with PECOS - Medicare enrollment a plus.
Hybrid upon successful completion of in office training.
Pay range $20-$24 per hour commensurate with experience.
IPractice offers a competitive salary and a comprehensive benefit package that encourage a healthy work/ life balance:
- 100% Employer Paid = Medical Health Insurance, Life Insurance for the employee and a robust, family friendly Employee Assistance Program (EAP)
- As well as 401(k) with Company Match and a Health Savings Account option
- Dental & Vision Insurance & AFLAC, employee paid options provided
- Generous Paid Time Off starting at 2 weeks and increasing tenure
WHO WE ARE
iPractice Healthcare Solutions is a Medical Service Organization, or MSO, that was created by the physicians of Austin Health Partners. We provide the services, tools and resources for practice needs to maintain independence while thriving in the continuously changing healthcare industry.
ESSENTIAL RESPONSIBILITIES:
Maintain client Provider personal licenses, history, and current volume data for maintenance of medical staff privileges, clinical certifications, and payer registration.
Maintain timely and accurate data entry and periodically revise practitioner data in the credentialing database; maintain practitioner paper and electronic data files for practitioners; use the CAQH system to submit practitioner data as required by some client health plans to credential individual practitioners.
Enroll practitioners with all health plans clients are contracted with; monitor and report on progress of each practitioner.
Ensure all practitioners' malpractice insurance is up-to-date and active
Monitor expiring licensure, board and professional certifications and other expirable documents with practitioners within the prescribed time frames as outlined in the policies and procedures, assisting practitioners with timely renewal as appropriate and escalating to manager and field management as appropriate.
Assist practitioners with obtaining new state licenses in areas identified by the clinical management team; monitor and report progress of each practitioner.
Process and maintain up-to-date Practitioners' Medicare and Medicaid credentialing.
Creates and maintains tracking tools to monitor market conditions and the impact of managed care contracts and government fee schedule changes.
Interact with healthcare plans as needed.
Works effectively as a team member with office staff and physicians.
Maintain patient and personnel confidentiality at all times.
Maintain a high degree of professionalism when dealing with physicians, patients and co-workers.
Prevents illegal, unethical, and improper conduct in our payer contracting.
**Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for their job. Duties, responsibilities, and activities may change at any time with or without notice.
EDUCATION & EXPERIENCE
Must Have
- High school diploma or GED
- 2 years Microsoft Word experience
- Four (4) years of experience working in a physician office or healthcare facility.
- Prior experience with physician credentialing and contracting or in the insurance industry.
Nice to Have
PHYSICAL DEMANDS & WORK ENVIRONMENT REQUIREMENTS
- Must have the ability to sit for long periods of time.
- Ability to commute to clinic and office locations for staff meetings, as required.
OTHER DUTIES
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
AAP/EEO STATEMENT
Ipractice Healthcare Business Solutions is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Job Type: Full-time
Pay: $20.00 - $24.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Application Question(s):
- Do you have at least 4 years of experience working in a physician office or healthcare facility?
Experience:
- Microsoft Word: 2 years (Required)
- physician credentialing: 1 year (Required)
Work Location: Hybrid remote in Austin, TX 78730