Do you have excellent organizational, customer service, and database management skills? We're looking for someone just like you.
This is a time to join a thriving company that can offer you the opportunity of upward mobility.
We are looking for a motivated administrative team member who can join our company as an Administrative Specialist focused on provider credentialing. This position plays a critical role in ensuring provider services are in compliance with the appropriate accrediting and regulatory agencies while developing and maintaining a working knowledge of the statues and laws relating to credentialing. You will ensure our physicians are ready to meet the needs of our patients.
What You Will Do:
You will be responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process for Chesapeake Eye Care Company’s affiliated providers (60-100 providers) in multi-state locations for our ophthalmic practice and surgery center platform. You'll act as a liaison among our physicians, payors and billing team.
- Lead, coordinate, and monitor the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
- Conduct thorough background investigations, research and primary source verification of all components of the application file.
- Maintain copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for providers.
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Sets up and maintains provider information in online credentialing databases and system.
- Tracks license and certification expiration for all providers to ensure timely renewals.
- Maintains confidentially of provider information.
- Identify issues that require additional investigation and evaluation, validate discrepancies and ensures appropriate follow-up.
- Prepare credentials file for completion ensuring file completion within time periods specified.
- Maintains corporate provider contract files.
- Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
What You Will Bring:
- Ability to be self -directed, organized, and be accountable for one’s own work product.
- Exceptional written and verbal communications skills.
- Excellent attention to detail.
- Database management skills including querying, reporting, and document generation.
- Ability to analyze and interpret a wide range of information, including legal and contract language, policies, standards, and guidelines.
- Ability to thrive in a fast-paced environment and acquisition-oriented.
- Excellent project management skills and the utilization of project management tools.
- Ability to make administrative/procedural decisions.
- Proficiency in MS Office (Word, Excel, PowerPoint; Outlook).
Education and Experience Requirements:
- Some college experience preferred; related bachelor’s degree a plus.
- Related experience and/or certification/license or actively pursuing certification is helpful but not required.
Benefits & Perks:
We offer competitive pay, comprehensive benefits, significant eye care discounts, continuing education allowances, 401(k), and many other employee benefit programs.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.