RCM Credentialing Specialist / Payor Enrollment Specialist

Job Description

Job Description

Description:

As a Credentialing Specialist for UnisLink, you will be responsible for the collection and input of all providers demographic information onto applications or payer systems. You will collaborate with various departments to gather necessary documentation, conduct thorough credential reviews, and maintain accurate databases of provider credentials. Additionally, you will be tasked with processing initial credential applications, re-credentialing applications, and privileging requests efficiently and accurately.

Ultimately, your role as a Credentialing Specialist will contribute to maintaining high standards of quality and compliance for our clients, ensuring that all providers meet the necessary qualifications and requirements for delivering exceptional patient care.

Key Responsibilities:

• Process provider applications and re-applications, initial mailing, review and loading into the database tracking system ensuring high quality standards are maintained.
• Renew medical licensure, hospital privileges and board certifications, DEA registrations and any other required credentialing documents for provider.
• Prepare weekly and monthly updates as requested
• Utilize critical thinking skills to reconcile errors/updates in a timely manner.
• Utilize spreadsheets by preparing and monitoring client specific statistics and updates these immediately as contracted provider numbers are received, for review by all internal staff as needed and is communicated to the appropriate parties.
• Provide application and technical support to other team members and clients.
• Develop and maintain documentation that assures the credentialing processes are complete and accurate.
• Conduct professional oral and written communications with Client’s staff, facility staff, payor sources and clients as needed. Professionalism is required in all aspects of communications.
• Comply with all state and federal billing rules and regulations including CMS, FDCPA, HIPAA, etc.
• Participate in identifying problems and suggesting solutions.
• Promote Unislink’s core values of Respect, Integrity, Customer Focus, and Continuous Improvement.
• Perform other related duties as assigned.

• Previous healthcare credentialing experience. The ideal candidate has payor/provider enrollment experience AND hospital credentialing experience.
• Basic knowledge of insurance law, guidelines, and application language, in addition to payor requirements such as specific form requirements and reimbursement methods.
• Proven ability to utilize critical thinking skills to demonstrate proficiency in reviewing applications and identifying requirements posed by individual payers.
• Highly organized to meet deadlines and work independently in a fast paced, multi-functional environment where tasks and assignments are constantly changing.
• Knowledge of Microsoft Office programs and tools.
• Experience assisting clients with maintenance of current compliance regulations.
• Demonstrates strong interpersonal skills with the ability to establish and maintain effective working relationships with staff, external agencies and clients.
• Prompt and dependable attendance.
• Values a high level of confidentiality and professionalism.

Why UnisLink?

We offer a competitive salary and benefits package, as well as opportunities for growth and development within the organization. Our total rewards package reflects our commitment to creating a diverse and supportive workplace.

• A positive work environment with passionate leaders that believe in collaboration, innovation, and career growth.
• Medical, dental and vision insurance for you and your dependents
• Healthcare Flexible spending accounts are available options
• 401(k) retirement plan with up to 4% match and no vesting period
• Paid parental leave
• 10 days of Paid Time Off (PTO) and 8 company paid holidays annually

About Us

Founded in 2009, UnisLink helps medical providers optimize revenues, improve outcomes and reduce costs through better process management, data analytics, and outsourcing. Throughout its journey to date, UnisLink has fostered an entrepreneurial culture and attracted and retained a highly skilled team of professionals in the areas of medical billing/RCM, data analytics, product development, account management and customer service to serve clients. The company is built upon the core values of Respect, Integrity, Customer Focus and Continuous improvement. UnisLink is committed to combining diversity, collaboration, and excellence. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, protected veteran status, or based on disability.