Paradigm Oral Surgery
Credentialing & Licensure Specialist
Paradigm Oral Surgery, Lincoln, Nebraska, United States, 68511
Role and Responsibilities
The Credentialing & Licensure Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, and commercial payers.
Roles and Responsibilities Maintains compliance with all regulatory and accrediting institutions. Manages individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. Maintains CE hours to ensure compliance with state regulations. Applies for and renews all provider licenses. Completes revalidation requests issued by government payers. Completes credentialing applications to add providers to commercial payers and re-credentialing applications for commercial payers. Partners with Clear Choice to ensure credentialing of new providers and re-credentialing current providers. Maintains provider credentials with hospitals at which they hold staff privileges. Facilitates Integration of Acquisition and required processes. Works closely with the Revenue Cycle team to identify and resolve any denials or authorization issues related to provider credentialing. Performs other duties as assigned. Education and Experience
High School Diploma or equivalent required. Associates degree in related field preferred. Two or more years of relevant experience required. Credentialing experience preferred. Skills and Abilities
Knowledge of provider credentialing. Excellent computer skills including Excel, Word, and Internet use. Detail oriented with above average organizational skills. Excellent customer service skills. Excellent written and verbal communication skills. Ability to plan, prioritize, and meet deadlines.
Core Benefits & Wellness
Medical (including Virtual Care), Dental, and Vision Coverage
Employee Assistance Program (EAP)
Financial Well-Being
Competitive pay, Bonus potential, and annual merit reviews
401(k) Plan w/Company Match
Health Savings Account (HSA) with HDHP health plans
Life Insurance
Basic and Supplemental Life Insurance
Spouse and Child Life Insurance
Time Off, Disability And Leave Of Absence
Paid Vacation (Starting at 2 weeks) and 6 Annual Paid Holidays
Long and Short Term Disability Plans
The Credentialing & Licensure Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, and commercial payers.
Roles and Responsibilities Maintains compliance with all regulatory and accrediting institutions. Manages individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. Maintains CE hours to ensure compliance with state regulations. Applies for and renews all provider licenses. Completes revalidation requests issued by government payers. Completes credentialing applications to add providers to commercial payers and re-credentialing applications for commercial payers. Partners with Clear Choice to ensure credentialing of new providers and re-credentialing current providers. Maintains provider credentials with hospitals at which they hold staff privileges. Facilitates Integration of Acquisition and required processes. Works closely with the Revenue Cycle team to identify and resolve any denials or authorization issues related to provider credentialing. Performs other duties as assigned. Education and Experience
High School Diploma or equivalent required. Associates degree in related field preferred. Two or more years of relevant experience required. Credentialing experience preferred. Skills and Abilities
Knowledge of provider credentialing. Excellent computer skills including Excel, Word, and Internet use. Detail oriented with above average organizational skills. Excellent customer service skills. Excellent written and verbal communication skills. Ability to plan, prioritize, and meet deadlines.
Core Benefits & Wellness
Medical (including Virtual Care), Dental, and Vision Coverage
Employee Assistance Program (EAP)
Financial Well-Being
Competitive pay, Bonus potential, and annual merit reviews
401(k) Plan w/Company Match
Health Savings Account (HSA) with HDHP health plans
Life Insurance
Basic and Supplemental Life Insurance
Spouse and Child Life Insurance
Time Off, Disability And Leave Of Absence
Paid Vacation (Starting at 2 weeks) and 6 Annual Paid Holidays
Long and Short Term Disability Plans