Credentialing Assistant

Multi-site Dermatology Group Seeks Credentialing Assistant

Optima Dermatology is recruiting a full time Credentialing Assistant join our Practice Support Center (Portsmouth, NH.) Remote opportunities available for candidates based in our employment hubs: ME, NH, IN, OH, FL, NC.

Position Summary:

The Credentialing Assistant will the support revenue cycle, provider support and credentialing teams. Their work will include managing accurate provider payer participation, licensing, and certification information. Additionally, they will be responsible for patient and insurance tasks within various systems and programs within RCM. Additional responsibilities may include serving as an internal service support, assisting with other administrative needs of the department and organization.

Responsibilities:

• Managing accurate Patient Statements within Electronic Health System and Third-Party Vendor Sites:
• Creating statement file and uploading file onto third-party vendor website
• Daily review of third-party vendor Bad Address Files and update patients account for next statement cycle
• Daily review of third-party vendor Forwarding Address Files and update patients account for next statement cycle
• Daily collection of returned patient statements from mailbox and use skip tracing resources to locate current residential information, update patients account for next statement cycle
• Meticulously maintains and tracks accurate provider and payer related information
• Work as a liaison between our credentialing, provider and revenue cycle teams collecting, reporting, and tracking information for provider payer and plan participation
• Submits all documentation needed to enroll providers timely to our credentialing team to expediate new and existing provider payer enrollments
• Review and management of RCM payer participation documentation ensuring information is always accurate and up to date
• Keeps meticulous records for provider plan enrollment. Tracks detailed payer information related to participation status and renewal requirements and deadlines
• Submits all required information to maintain provider participation status with payers and plans ahead of schedule avoiding any lapses in participation and claims processing
• Keeps meticulous records on all provider licensing and certifications. Tracks all licensure and certification requirements as well as renewal dates and re-enrollment deadlines
• Works with provider support team to gather all required forms, materials including payment information and submits timely to avoid any license or certification lapses
• Manage assigned tasks in Electronic Health System:
• Daily review of outbound correspondence tasks ensuring items are printed and mailed in a timely manner
• Daily review referral and authorization inquiries by verifying patient insurance coverage and eligibility for services
• Consistently operate within and is measured on ability to build rapport, actively listen, follow up and manage patient correspondence, internal and external communication, service and support, critical thinking, planning, and problem solving
• Consistently achieve expected goals including but not limited to completion of assigned daily activities, adherence to work schedule, practice management system, quality, and compliance
• Work as a collaborative team member within a distributed organization demonstrated by; communicating effectively with leaders, providers, practice staff and co-workers.  Participate in team/staff meetings and maintain a positive attitude
• Adheres to all HIPAA guidelines, complies with annual training
• Demonstrate strong Interpersonal skills, excellent written and verbal communication, and adheres to documentation expectations
• Maintain compliance with attendance and punctuality requirements and all other policies outlined in the employee handbook
• Other duties assigned by the Supervisor, Manager, or Director  

Qualifications:

• High school diploma/GED required.  Some college preferred.
• MUST be detailed oriented
• MUST be passionate about record keeping and tracking dates and deadlines
• Intermediate to master user of excel and data base programs 
• Knowledge of business administration preferred
• Medical terminology and insurance industry terminology preferred
• Intermediate understanding of and Explanation of Benefits preferred
• Experience with ModMed or similar EMR preferred
• Must have excellent time management skills and ability to adjust priorities quickly and comfortably
• Ability to communicate in a clear and professional manner 
• Ability to solve problems, prioritize duties, and follow through with assigned tasks 
• Ability to work independently in fast-paced environment 

Compensation

The position will offer competitive compensation. In addition, it will offer the personal reward associated with transforming our patients’ lives and building the most defensible healthcare services platform in the country.

Benefits

Our benefits include generous health, dental, vision, disability, and life insurance.

About Optima Dermatology

At Optima Dermatology, our mission to revolutionize skin care is made possible by our world class team that is highly engaged, mission-driven, and inspired to set the new standard in dermatology. We are growing rapidly and looking for key team members who believe in our mission and want to make a difference in the lives of our patients. We foster a collaborative environment that is fun and hardworking and promise you will work alongside amazing colleagues you are proud to call your teammates.