Credentialing Team Lead

 Posted a month ago
     
2-5 years experience
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AI Summary

Manage provider credentialing and contract applications with third-party carriers and government health plans. Serve as the team lead to handle escalated matters and ensure accuracy across internal and external databases.

Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner. We are seeking to add a Credentialing Team Lead to our growing team. If you are looking for a rewarding position where you can work with industry experts and actively grow in your career, this position is for you. The ideal candidate is passionate, motivated, detail-oriented and interested in gaining knowledge and new skills.

This is a remote or hybrid in-office/remote role.

Your Responsibilities:

  • Complete provider credentialing and contract applications with third-party carriers and government health plans.
  • Review provider credentialing and contracting information to ensure completeness and accuracy.
  • Monitor applications and follow-up in a timely manner.
  • Document, maintain and crosscheck client credentials in multiple databases, including CAQH and other third-party databases, as applicable.
  • Create, update and track provider information in the internal credentialing system to ensure that credentials are completed timely and correctly.
  • Research new state and payer information and guidelines. 
  • Serve as a go-to person for credentialing team.
  • Assist with escalated credentialing matters. 
  • Meet or exceed required timeframes for provider communications, enrollments, and follow-ups.
  • Maintain quality working relationships with internal and external customers.
What we offer you:
  • A close-knit team of talented and skilled individuals
  • Growth opportunities within the organization
  • Competitive salary
  • Healthcare benefits including medical, dental & vision, 401K
  • Flexible PTO
Qualifications:
  • 3-5 years of experience in credentialing and contracting.
  • Knowledge of Commercial Insurance and Government Payor guidelines.
  • Ability to plan, organize, and complete work with competing priorities.
  • Takes accountability for personal productivity and quality of output.
  • Organized and detail-oriented with strong communication and problem-solving skills.
RCM Analyst | Revenue Cycle Credentialing Specialist | Insurance Specialist | Revenue Cycle Contracting Specialist | Medical Billing Specialist | Revenue Cycle AR Collections Specialist | Billing and Reimbursement Specialist | Billing Specialist |Billing Coordinator | Claims Specialist | Billing Representative | Collections Specialist | ABA Billing Specialist | ABA Claims Specialist | Behavioral Health Billing Specialist 

#RCMAnalyst | #RevenueCycleCredentialingSpecialist | #InsuranceSpecialist | #RevenueCycleContractingSpecialist | #MedicalBillingSpecialist | #RevenueCycleARCollectionsSpecialist | #BillingandReimbursement Specialist | #BillingSpecialist | #BillingCoordinator | #ClaimsSpecialist | #BillingRepresentative | #CollectionsSpecialist | #ABABillingSpecialist | #ABAClaimsSpecialist | #BehavioralHealthBillingSpecialist | #ABACollectionsSpecialist

 

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