Credentialing / Insurance Verification Orthotic & Prosthetic Solutions LLC Mobile, AL Job Details Full-time $18 - $25 an hour 1 day ago Benefits Health insurance Dental insurance Paid time off Vision insurance Qualifications Microsoft Excel Microsoft Outlook Multitasking Insurance verification Medical insurance coverage verification Attention to detail Organizational skills Full Job Description Job Overview We are seeking a detail-oriented and proactive Credentialing / Insurance Verification Specialist to join our healthcare team. In this vital role, you will ensure the accuracy and completeness of provider credentials and verify insurance coverage efficiently to facilitate seamless patient care and billing processes. Your expertise will support compliance with healthcare regulations, payer requirements, and accreditation standards, contributing to the overall integrity of our healthcare operations. This position offers an exciting opportunity to work within a dynamic environment where precision, compliance, and excellent communication are essential. Responsibilities Review and process medical credentialing applications to ensure completeness and compliance with regulatory standards such as NCQA, JCAHO, and CMS. Verify insurance coverage for patients by contacting payers, utilizing healthcare software applications, and managing databases to confirm eligibility and benefit details. Maintain up-to-date knowledge of health insurance policies, state healthcare regulations, and CMS guidelines to ensure accurate verification procedures. Manage medical payer enrollment processes, including submitting applications and tracking approval statuses in accordance with healthcare compliance standards. Utilize medical credentialing software and healthcare software applications to document verification activities accurately and securely handle confidential information. Collaborate with providers, insurance companies, and internal teams to resolve credentialing or insurance issues promptly while adhering to accreditation standards. Ensure all credentialing records are maintained in compliance with regulatory requirements such as JCAHO standards and CMS regulations for audit readiness. Skills Strong understanding of managed care systems, health insurance policies, and state healthcare regulations. Proven experience in medical credentialing application review, provider enrollment, and payer verification processes. Proficiency in Microsoft Office Suite (Word, Excel, Outlook) for documentation and communication purposes. Familiarity with medical credentialing software platforms and healthcare software applications for database management. Knowledge of healthcare compliance standards including NCQA accreditation requirements and CMS regulatory guidelines. Excellent organizational skills with the ability to manage multiple tasks while maintaining attention to detail. Effective communication skills for liaising with payers, providers, and internal teams in a professional manner. Join us in delivering exceptional healthcare support through meticulous credentialing and insurance verification! Your expertise will help uphold our commitment to regulatory excellence while ensuring smooth operational workflows that benefit both patients and providers alike.

Pay:

$18.00 - $25.00 per hour

Benefits:

Dental insurance Health insurance Paid time off Vision insurance

Experience:

Insurance verification: 1 year (Required)

Work Location:

In person