Credentialing Specialist

Credentialing Specialist

J & S Stark Billing & Consulting Inc. is a Medical Billing Company specializing in physician billing. We are looking for a full time Credentialing Specialist to add to our team We are located in Shrewsbury (Monmouth County) N.J. J & S Stark Billing & Consulting Inc. was established over 25 years ago & continues to earn the respect trust & business of over 300 medical providers.Credentialing SpecialistCredentialing specialists maintain regular cooperation and compliance with all regulatory and accrediting organizations. They create and carry out various credentialing processes in relation to physicians and healthcare providers. The specialist ensures that all personnel and services adhere to credentialing guidelines regulations and government laws.Credentialing specialists process applications and reappointment paperwork checking for completeness and accuracy. They collect and process significant amounts of verification and accreditation information and constantly maintain and update accurate databases for both practitioners and facilities. These databases include pertinent education training experience and licensure content. Credentialing specialists maintain close communication with all appropriate practitioners to ensure that records are up-to-date and consistent.Responsibilities New Physicians Obtain a Universal Application and all required documents Verify all information on file with the insurance companies tax Id addresses specialty etc Verify info on NPI Registry. Verify all products within the insurance companies Submit all re-credentialing applications Verify the most recent 5-year period available for sanctions or limitations on licensure in state where the practitioner provides careExisting Physicians Submit updates & corrections to insurance companies If physician is not participating verify if they want to apply. If so submit application for physician. Follow up on application for the status until the application has been approved Verify the most recent 5-year period available for sanctions or limitations on licensure in state where the practitioner provides carePECOS Maintain the physicians files for revalidation or make any changes for Medicare Medicare Opt Out -Login to NGS and verify if any physicians opted out of Medicare Revalidation List Login to NGS every month and verify if any of our physicians are listed CAQH Create and populate their CAQH file Maintain and update all our Doctors files Re-attest their file every 90 daysDelegated Submit updates on a monthly basis Qualifications At least 2 years credentialing experience High School Diploma or equivalent Proficient computer skills including Microsoft Word Excel Outlook ability to navigate the Internet with ease and use telephone equipment including headset or handset Must be detail oriented with strong organizational time-management and interpersonal skills Demonstrate excellent reading verbal and written communication skills and data entry skills Ability to work jointly with management supervisors employees clients etc. Must adhere to regular and predictable attendancePhysical Demands The Physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position. Requires sitting for extended period of time with occasional stretching reaching walking and stooping pushing and or pulling Must be able to type for extended periods of time Requires being able to hear and speak with others both in-person and on the phoneBenefits Salary commensurate with experience Excellent Medical and Dental Plans Retirement plans & Life insurance options Vacation holiday and sick time Flex schedulesIndividual must be able to adapt to an ever changing busy environment. Candidate must be reliable and a team player with a positive attitude having excellent computer and verbal written communication skills for provider and staff interactions.This is a high volume fast paced and exciting environment. We have a strong team supportive management & offer a casual work environment.