Credentialing Specialist

Job Details: Job Location: Cumberland FMC Admin

• Russell Springs, KY, Position Type: Full Time, Salary Range: Undisclosed, Job Category: Admin
• Clerical, Credentialing Specialist Cumberland Family Medical Center (CFMC) operates a Federally Qualified Health Center (FQHC) offering a wide range of health and social services at multiple sites throughout Kentucky. We seek employees who support our mission and who actively contribute to our service-driven environment by enhancing patient experience and improving productivity. CFMC offers compassionate care, uncompromising service and clinical excellence. We offer a collaborative environment with excellent benefits, wage/salary commensurate with experience and relevant work experience.

Duties and Responsibilities

Enrolls physicians with contracted payers and maintains current and organized records of all credentialing information to include completing applications, obtaining signatures, providing necessary documents to complete the credentialing process. Maintains provide listings with Medicare, Medicaid, and other carriers. Performs initial contact with contracted payers to initiate credentialing process and enable a relationship with the provider and network representatives.

Maintain and update accurate reports regarding provider participation. Responsible for setting up and maintaining provider and group records. Maintains credential database in accordance with time standards. Reviews credentialing applications for completeness and accuracy of documentation according to specified standards for submission to insurance carriers for credentialing.

Communicates and tracks applications with payers to ensure timely and accurate credentialing of providers. Review records for completeness, accuracy and compliance with regulations. Maintain and update accurate reports regarding provider participation. Other duties as assigned.

Qualifications

Education/Experience: High school diploma/GED. A minimum of 2 years’ related experience in credentialing or equivalent combination of education and experience. Must have good communication skills. Proficient in MS Outlook; MS Excel and MS Word. Schedule Requirements: Full-time position, 5 days per week, 100% office-based, in person work required.

Work schedules are set at the discretion of CFMC and may be adjusted at any time based on the operational needs of the organization.

Compensation

Negotiable based on experience Benefits: Health, Vision, Dental, Life, STD, LTD, 401K, PTO, and Holidays