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Medical Payer Credentialing Specialist

Medical Payer Credentialing Specialist

Reports to: Revenue Manager
Employment: Full-Time, Non-Exempt
Company Summary:

StationMD is a telehealth company dedicated to serving individuals with intellectual and/or developmental disabilities (I/DD). All StationMD clinicians are board-certified and specially trained to treat individuals with I/DD. Clinicians are available 24/7 via telemedicine for urgent and non-urgent medical matters. StationMD also offers scheduled psychiatry telemedicine to individuals with I/DD. In providing this suite of services, StationMD enables individuals with I/DD faster access to high-quality care and substantially reduces unnecessary medical costs.

Position Summary:

We are seeking a Medical Payer Credentialing Specialist with a desire for details and a heart for helping others. Everyone on our office team has a role to play in providing great customer service for a broad cross-section of clients, so you will get to use your excellent communication and interpersonal skills in this demanding role. We want you to succeed and provide you with all the support you need so you can grow in your job and your career.

Essential Duties & Responsibilities:
  • Initiate enrollment with insurance companies for all new providers
  • Maintain the timelines on enrollment schedules, communicate with billing and the office managers on updates as needed, and explain payer information requirements
  • Work closely with physicians and office mangers to obtain missing documentation on providers for enrollment with insurance companies
  • Follow-up with insurance companies for provider participation status
  • Complete re-credentialing for existing providers
  • Communicate with team members, billing staff, and insurance companies
  • Retain detailed and accurate lists of insurances for which clients participate
  • Perform other related duties, which may be inclusive, but not listed in the job description
Qualifications

Education/Certification

  • High School Diploma or GED required
  • Bachelor’s degree in business, finance, accounting, or a similar field
  • Minimum of 2 years’ experience in provider enrollment preferred
  • Medical Billing experience a plus

Qualifications/Requirements

Required:

  • Strong written and verbal communication
  • Excellent active listening skills
  • Above-average customer service skills
  • In-depth knowledge of industry practices
  • Comprehension of industry-specific policies
  • Excellent organizational skills
  • Ability to remain discreet and keep practitioner information confidential
  • Knowledge of the Medicare, Medicaid & third-party provider enrollment processes
  • Accuracy and attention to detail
  • Database and query software

Preferred:

  • Minimum of 2 years in a credentialing role
  • Excellent attention to detail
  • Excellent interpersonal skills
  • Proficiency in CAQH, PECOS & NPPES
HealthTech Partners, Inc/StationMD, PC is an affirmative action equal opportunity employer.

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