Credentialing Specialist bei North Pittsburgh Oral Surgery Assoc. LTD

Description

Job Summary

North Pittsburgh Oral Surgery (NPOS) has supported communities in and around Western Pennsylvania for 60 years. As a large specialized group of Board-Certified Oral Surgeons, we have high expectations for our patients' care and for our team to exceed their needs. As a reflection of that and in consideration of our planned growth, we are looking for exceptional talent to join our "family-centric" team, where we believe supporting you comes first.

As a Credentialing Specialist supporting dental and medical credentialing, you verify, collect, and maintain provider credentials like licenses and certifications to ensure our healthcare professionals meet regulatory and payer requirements for practice. You will act as a Billing Specialist during any down time. Credentialing Specialists are crucial for providers to get credentialed with insurance plans, bill for services, and maintain regulatory compliance. Ensuring consistent payment and mitigating any stress with payor relations and patients.

You will effectively communicate with patients, doctors, coworkers, and referring physicians. Your outlook, demeanor, and interaction with others are a reflection of both the doctors and the practice.

Through teamwork, communication, and attention to detail, you are an integral part of our success. It's your involvement that makes us great.

Requirements

Essential Functions and Responsibilities:

Manage and maintain provider credentialing files, including licensure, certifications, professional references, and continuing education documentation.

Complete and submit credentialing and re-credentialing applications for Surgeons and other Clinical Providers.

Track credentialing status with insurance networks, hospitals, and other credentialing bodies to ensure timely approvals.

Monitor expiration dates for provider licenses, DEA, board certifications, and other required documentation, sending timely reminders for renewals.

Maintain provider enrollment with Medicare, Medicaid, and commercial insurance plans.

Serve as the primary point of contact for credentialing-related inquiries and collaborate with providers, payers, and internal departments as needed.

Experience:

High school diploma or equivalent required.

Previous experience in the dental industry preferred.

Previous experience in credentialing, medical records, health information management, or legal records processing required.

Knowledge of HIPAA, medical terminology, and healthcare documentation standards.

Strong attention to detail and ability to follow instructions accurately.

Excellent written and verbal communication skills.

Strong multitasking and interpersonal skills.

Proficiency in electronic medical records (EMR) systems and Microsoft Office Suite.

Ability to work well in a fast-paced, high-pressure environment.