The Provider Specialist is responsible to coordinate all functions related to credentialing, re-credentialing, and maintaining providers according to established guidelines, policies, and procedures. The Provider Specialist is also responsible for ensuring the integrity of credentialing data and entering of data into the Provider database. This includes both written and telephonic communication with providers.
This position is responsible for the set-up and ongoing maintenance of individuals, providers enrolling for electronic claims reimbursement and assignment of benefit requests.
Required to uphold the principles of compliance and fraud management as outlined by corporate and departmental policies. Supports and participates in the mandatory training on an annual or more frequent basis, as required.
Strong attention to detail and proven follow-through on assigned tasks is required. Intermediate Microsoft Office Suite skills. Ability to communicate effectively with internal and external customers.
Effective oral and written communication. Highly organized. Excellent attention to detail and follow through.
Ability to set priorities in a multi-task environment. Must be able to work independently, as well as be team oriented. Strong technical aptitude with excellent analytical and problem solving skills.
Excellent customer service skills. High School Diploma or equivalent.
Previous experience in provider credentialing within the managed care, Medicare Advantage, or long term care environment, preferred.
FedPoint is an equal opportunity employer. Our company is a Vietnam Era Veterans' Readjustment Assistance Act (VEVRAA) federal contractor and committed to hiring veterans.
Long Term Care Partners