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Remote Credentialing Verification Organization Jobs in Georgia

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Remote Credentialing Verification Organization information

What is the difference between Remote Credentialing Verification Organization vs Credentialing Specialist?

AspectRemote Credentialing Verification OrganizationCredentialing Specialist
Primary RoleProvides credentialing verification services for healthcare providers remotelyPerforms credentialing tasks directly for healthcare facilities or providers
Work EnvironmentTypically operates remotely, often for multiple clientsUsually works in healthcare facilities or administrative offices
Required CredentialsKnowledge of credentialing standards, healthcare regulationsCertifications like Certified Provider Credentialing Specialist (CPCS) often preferred

The main difference is that a Remote Credentialing Verification Organization offers credentialing services remotely for multiple clients, while a Credentialing Specialist performs credentialing tasks directly within healthcare organizations. Both roles require knowledge of healthcare standards, but their work settings and scope differ.

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Remote Credentialing Verification Organization jobs near you

Credentialing Specialist - PRN

Augusta, GA • On-site, Remote

Center for Primary Care
See more jobs at Center for Primary Careexternal

Other

Posted 4 days ago

Job description

Description
Credentialing Specialist - PRN
Center for Primary Care
Who we are:
For over 30 years the Center for Primary Care (CPC) has cared for families in the CSRA by providing patients with the most convenient, accessible, and personal healthcare available. Our mission is to improve the health and wellbeing of the families we serve by providing compassionate and high-quality care in a joyful setting. The physicians, healthcare professionals, and support team at our 10 practices, plus laboratory, imaging, and corporate locations work to transform our mission into action.
What our employees say:
At Center for Primary Care, we understand that the work environment is as important as the hard work you do. Center for Primary Care is Great Place to Work Certified which means our employees share feedback on their work culture experiences and we listen and strive to create positive employee experiences centered on joy, trust, and belonging.
Learn more about CPC's culture and Great Place to Work Certification by clocking on the link below:
Working at Center for Primary Care | Great Place To Work®
Benefits for you and your family:
A work schedule that allows you to thrive both professionally and personally.
Mental Health Support Services and Resources.
Employee Discount Programs.
Credentialing Specialist - PRN
Key Responsibilities:
Essential Functions
Reporting to the Credentialing and Director of Applications, the PRN Credentialing Specialist supports the Clinical Applications & Credentialing Support Specialist in facilitating accurate and timely credentialing and enrollment efforts for CPC's providers and supports the administration and optimization of all payer related credentialing and enrollments providing support in troubleshooting credentialing and payor-related denials & rejections.
Key Responsibilities:
Essential Functions
  • Supports the Clinical Applications & Credentialing Support Specialist in the following areas:
    • New provider credentialing and established provider re-credentialing activities
    • Keeping all applicable credentialing databases and spreadsheets up to date
    • Monitoring expiration dates and assists with the renewals of provider licenses, certifications, etc.
    • Maintaining payer rosters, including necessary communication with health plan provider representatives
    • Resolving credentialing- and enrollment-related issues
  • Stays up to date on relevant state and federal regulations, etc.
  • Performs additional duties and responsibilities, as necessary.
  • Works closely with the Clinical Applications & Credentialing Support Specialist
  • Assist in other projects and needs as they come up
  • Maintains confidentiality of all protected health information (PHI) and personally identifiable information (PII).
  • Performs job in compliance with organization policies and procedures as well as community standards and applicable laws.
  • Promotes positive public relations to patients, visitors, families, physicians, and others. Exhibits characteristics consistent with CPC values for quality, respect, teamwork, and pride.

All essential functions must be performed. Reasonable accommodation may be provided to enable individuals with qualified disabilities to perform the essential functionsThe above information is intended to describe the general nature and level of work being performed by people assigned to this job. It is not intended to be an exhaustive list of responsibilities, duties and skills required of personnel so classified. Examples listed do not preclude the performance of other duties similar in nature or in level of complexity.
Requirements
Qualifications for Success:
Education, License/Certification, and Experience Requirements
Education and Experience Required:
  • High School Diploma or GED required.
  • 2+ years' experience in credentialing, health information management, medical billing, health informatics, or a related field.
EDUCATION AND EXPERIENCE PREFERRED:
  • Credentialing experience, medical billing/coding, or a related field.
  • Database Management, Excel and/or SQL knowledge.
  • Experience in Medical Provider Credentialing, payer enrollment, and/or data analytics preferred.

Essential Skills:
  • Eager and able to embody CPC's mission, especially to serve joyfully
  • Willing and ready to work collaboratively for the good of the team
  • Knowledge of health systems, providers, licensing, and credentialing processes
  • Able to manage time, keep timelines and, at times, work well under pressure
  • Very high attention to detail
  • Advanced organizational and problem-solving skills
  • Able to communicate effectively and succinctly, in writing and verbally
  • Strong overall computer skills and intermediate knowledge of Microsoft Word and Excel
  • Able to work with diverse populations
  • General ability to navigate websites and payer portals

AdditionalJobDetails:
Work Setting: Remote - United States
Job Type: PRN
Schedule: Monday-Friday, less than 30 hours per week. Weekly hours will fluctuate based on the needs of the business.
Compensation: Market competitive base pay, commensurate with education and experience.

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