Credentialing | Neptune, NJ | Full Time
Medi-Centrix offers next generation healthcare Business Intelligence and Revenue Cycle Performance Management technology solutions, workflow driven outsourced services, and expert advisory capabilities honed by many years of direct operational experience. Our mission is simple: To help our clients improve their margins and efficiency. Founded in 2010 by a veteran management team with an established track record of providing superior service and technology to the Healthcare Industry, the team includes former leaders of National Revenue Cycle firms, Hospital Turnaround Management businesses, and Managed Care companies. We provide a full spectrum of Revenue Cycle and Business Intelligence software and consulting from Receivable and Revenue Valuation to Dashboard Analytics; and are looking for the right person to join our team!
Medi-Centrix provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Medi-Centrix complies with applicable state and local laws governing nondiscrimination in employment in every location where the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Responsible for credentialing/enrolling new and established health care providers and maintenance of required information.
Duties and responsibilities
- Meets with providers to explain process and sign applications
- Collects, updates, maintains necessary provider information and documentation and verifies the information where possible.
- Establishes and maintains data entry in CAQH.
- Prepares credentialing applications for all initial applications and re-credentialing in a timely and complete manner.
- Verifies provider and group information with insurance companies (addresses, contracted plans, provider ID numbers, etc.).
- Coordinates information for enrollment and termination of all providers.
- Handles enrollment with Medicare, Medicaid, commercial insurances.
- Contributes to the departmental process and procedures with a collaborative approach.
- Performs other duties as requested.
- High School graduate or equivalent
- Minimum two years of provider enrollment experience
- Knowledge of Microsoft Word, Outlook, Excel, CAQH
- Billing knowledge and experience preferred
(Med-Metrix or MediCentrix) will not discriminate against any employee or applicant for employment because of race, creed, color, sex, religion, national origin, military status, sexual orientation, age, disability, genetic disposition or carrier status, domestic violence victim status, or marital status, will undertake, or continue existing programs of affirmative action to ensure that minority group members and women are afforded equal employment opportunities without discrimination, and will make and document its conscientious and active efforts to employ and utilize minority group members and women in its work force. It shall also follow the requirements of the Human Rights Law with regard to non-discrimination on the basis of prior criminal conviction and prior arrest.