Credentialing Specialist

Inception Fertility is a family of patient-centered, tech-enabled brands that together seek to redefine the fertility patient experience. We believe every great patient experience starts with a great employee experience and strive to provide our staff with everything they need to consistently deliver safe, efficient, and compassionate patient care.

We are looking to hire an organized and motivated Credentialing Specialist to assist us with tasks and related projects pertaining to our Physician and practitioners' credentialing and third-party payor contracting. The Credentialing Specialist will build, organize, verify and maintain up-to-date files on all Physicians and practitioners. This includes tracking the expiration of certifications and CAQH profiles.

ESSENTIAL RESPONSIBILITIES:

• Ensure protocols are being followed to guarantee timely resolution and completion of payor enrollment in order to prevent loss of revenue due to untimely payor enrollment.

• Accurately prepare all required paperwork for provider payor enrollment/re-enrollment.

• Accurately document tasks in the departmental tracking system

• Audit all paperwork before submitting to ensure the paperwork is completed and the data is accurate.

• Provide weekly status reports of open items/projects to management.

• Responsible for communicating any potential issues with providers who have not completed required paperwork.

• Ensure quantity and quality of work meets departmental productivity/quality standards.

• Process initial credentialing and re-credentialing applications

• Audit practitioners' applications and supporting documentation

• Identify discrepancies in information and conduct follow-ups

• Assist third party payors with credentialing inquiries

• Respond to provider and practice management inquiries

• Ensure data is complete accurate in credentialing database and other internal sources

• Must be able to multi-task and work both independently and as part of a team; and able to successfully work with practices in multiple states

• Assists with special projects as needed.

• Other duties as assigned.

KNOWLEDGE AND SKILLS:

• High school diploma or GED required; Associates degree or equivalent experience preferred

• 3+ years credentialing experience in a managed care or hospital setting highly preferred

• Excellent verbal and written communication skills

• Experience with credentialing databases preferred

• Demonstrated knowledge of third-party and insurance company operating procedures, regulations and billing requirements

• Previous experience with privilege requests for physicians for hospitals and other healthcare facilities required

• Working knowledge of payor credentialing rules and regulations

• Experience working with Council for Affordable Quality Healthcare, Inc (CAQH)

Inception offers fantastic benefits to our team (Family members):

• FREE employee only coverage option for the medical, dental and vision plans plus FREE basic life insurance, EAP and long-term disability insurance!

• Adoption assistance and fertility benefits

• Maternity and paternity/partner paid leave

• 401k with generous match

• 11 Company-paid holidays (1 floating holiday)

• PTO starting at 18 days/year

• Family member recognition program

• Professional, collaborative, team-centered work environment

• Continuing education/professional development reimbursement and time off

• Family member referral program