The Credentialing & Contracting Specialists manages provider credentialing and works with the Revenue Cycle Manager (RCM) to negotiate payor contracts.  The position also works closely with the Chief Medical Officer (CMO) and Quality Care Manager.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Manage credentialing of providers and facilities with third party payors

Work with CMO to maintain files for clinical staff and provider privileging

Maintain documents for clinical staff / providers for HRSA reporting

Run and evaluate patient insurance eligibility reports in the EMR

Work with RCM manager to update rates with all payors

Work with RCM manager in communicating with payers for contract renewals and negotiations

Support the organization’s Mission, Vision, and Values.

Perform all other appropriate duties as assigned based on skill set.

EDUCATION

High School Diploma or equivalent

EXPERIENCE

Prior medical office credentialing experience preferred
Experience with managed care contracts and payer incentive programs helpful

Compensation details: 18-20 Hourly Wage

PI7f26e2e755a1-37437-40411701

Amistad Community Health Center

Latest Jobs

Credentialing & Contracting Specialist