Payor Credentialing Specialist

Payor Credentialing Specialist Syracuse, NY Job Details Full-time $65,000 - $80,000 a year 2 days ago Benefits Health insurance Dental insurance 401(k) Flexible spending account Tuition reimbursement Employee assistance program Vision insurance Employee discount Life insurance Qualifications Medicare Accreditation standards (regulatory compliance area) Managed care Medical office experience Regulatory compliance Mid-level Databases High school diploma or

GED EMR/EHR

Bachelor's degree Organizational skills Productivity software Medical terminology 2 years Healthcare compliance Communication skills Project stakeholder communication Stakeholder management Full Job Description Since 1887, Crouse Health has been a leading healthcare provider in Central New York. We've combined a family-friendly culture with a passion to provide the best care, which creates an environment where both patients and team members feel valued. Crouse Health offers a full range of general and specialty care, inpatient and outpatient services, as well as community health education and outreach programs. Crouse's Medical Staff Administration team is hiring a Payor Credentialing Specialist to credential all newly hired clinicians (MD, NP, PA) with all participating insurers for Crouse Hospital and Crouse Medical Practice.

Pay Range:

$65,000.00 - $80,000.00 / annual

Schedules:

Monday-Friday, 8:00am-4:30pm

Payor Credentialing Specialist Position Responsibilities:

Credential newly hired clinicians with applicable insurance payers for timely billing. Collect, Submit, & Track all necessary documentation. Process re-credentialing for existing clinicians as required by individual payers. Maintain a current, accurate database of all clinicians' credentialing / licensure status, needs, expirations, issues, etc. Share with internal staff as applicable. Communicate & Coordinate with all levels of internal staff & external stakeholders to ensure timely & consistent qualification is met & maintained. Monitor expiring credentials to ensure ongoing compliance with regulatory guidelines. Investigate and resolve any issues that arise during the approval process. Under the direction of leadership, assist with site level enrollments or changes to contract. Other duties as deemed necessary. Assumes other duties as assigned by department leadership.

Payor Credentialing Specialist Position Requirements:

High School Diploma or GED required, Bachelor's Degree preferred. Minimum of 2 years' experience in provider enrollment required. Knowledge of Medicare, Medicaid & third-party provider enrollment processes. Strong understanding of managed care processes. Experience working in a medical office or healthcare setting. Familiarity with medical terminology and its application in credentialing. Previous experience with NCQA standards or similar accreditation processes. Professional written and verbal communication and interpersonal skills. Excellent organizational skills with a keen eye for detail. Ability to communicate effectively with diverse stakeholders Proficiency in Microsoft Office and EMR systems, EPIC preferred. Proficiency in

CAQH, PECOS & NPPES

preferred.

Benefits Overview:

Medical, Dental, Vision, FSA, and 401K. Company paid life insurance. Tuition Assistance and Workforce Development Opportunities. Crouse Health Employee Assistance Program. Employee discounts on any Inpatient or Outpatient service, hospital cafeteria and pharmacy, and certain retailers. YMCA Subsidy program.

Location:

Crouse Hospital • Medical Staff Administration - 111

Schedule:

Full-Time, Days, 8:00-4:30