(Contract) Credentialing Specialist

We hold ourselves to exceptionally high standards in order to provide unparalleled service to healthcare professionals, their staff and patients. We strive to end each workday knowing that we’ve made someone’s life better.Our team is comprised of courageous and caring healthcare warriors. We’re here to solve the impossible problems, such as reducing medical errors, saving patient lives, and empowering physicians to stay financially independent. We care deeply about making a big impact and we are relentless.Inspired to grow the company and our careers, we remain committed to daily discipline, self improvement, and a ceaseless search for solutions.We equally value our work and our life apart from work. We’re compelled to work with urgency, decisiveness, and efficiency in everything we do. This affords us freedom and time for things that matter most. Leaders at pMD are developed through our mentorship program. Investing in the success of each individual strengthens our team and builds loyalty. We believe in leading by example. Everything one does ripples outward. Therefore, we need each individual at pMD to embody our core values to thrive as an enduring great company.

(Contract) Credentialing Specialist

(Contract) The Credentialing Specialist Contractor role at pMD is responsible for completing contracting and credentialing applications, claims and remittance agreements, EFT enrollment applications, changes in medical practice information, participation status, roster updates, and follow up calls on these tasks. This entails transcribing practice and individual provider data into PDF forms or portal-based forms. This plays a vital role in maintaining accuracy and efficiency with our credentialing process. By diligently completing and following up on applications, our team helps to ensure that our carrier network remains robust and our clients receive the highest quality service.

Responsibilities include:

• complete requests to contract and credential with insurance carriers
• complete applications for group contracting and individual provider credentialing with insurance carriers
• complete initial and reappointment applications for privileges at healthcare facilities
• request changes in practice demographic information with insurance carriers
• complete claims and remittance agreements via clearinghouse software and payer portals
• complete and submit Electronic Funds Transfer enrollments to establish electronic payments from the insurance carriers
• perform outreach to insurance companies to confirm status of applications and other change requests, including changes in medical practice information, participation status, and status of roster updates
• review previous notes pertaining to credentialing requests in order to achieve the goal of each outreach attempt
• record details about outbound calls to insurance carriers using task management software
• document clear instructions regarding the next steps when applicable
• communicate regularly with the Credentialing Department regarding any urgent matters, as well as weekly availability

Requirements include:

• experience completing contracting/credentialing applications and outreach
• experience/exposure to completing EDI agreements, preferred
• experience/exposure to completing EFT agreements, preferred
• availability during insurance carrier business hours (Monday - Friday, 8 am - 5 pm EST)
• knowledge of basic medical credentialing and administrative terminology
• exceptional attention to detail
• must be able to work independently in a fast-paced environment
• strong communication and problem solving skills
• reside in the US

The compensation model for this role is designed to pay on a per-unit of completed work basis, allowing ultimate flexibility in how and when you want to work. Payment per task is as follows: Follow-Up Call: $3.98/unitInitial Hospital Privileges: $13.44/unitAddress Update: $2.98/unitRoster Update/Initial Request/Link Provider: $5.97/unitInitial Contracting/Credentialing Application: $13.44/unitRe-credentialing/Reappointment Application: $8.96/unitCAQH Attestation: $2.98/unitERA Enrollment: $5.97/unitEFT Enrollment: $5.97/unitThere are no minimum requirements for working hours or hours per day for this position, but it does require availability between 8 am and 5 pm EST. Work is available on a first come, first serve basis, and you have complete flexibility on how many calls you want to make based on your free time and to meet your compensation goals.We are only accepting applications through our online job portal, Lever. We aren't able to consider and respond to other types of applications, including those sent via email to pMD support, at this time. Please direct application status questions to [email protected]. Candidates must be authorized to work in the U.S. as a precondition of employment.

Originally posted on Himalayas

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