Credentialing Specialist

Overview:

To accomplish this, we're looking for an individual who shares our sense of excellence, is ready to embrace change, never settle for the status quo, who has the confidence to develop a new arm to our services, and who never wants to stop learning/improving.

Responsibilities:

• Obtain pertinent data from providers to initiate the credentialing process
• Perform quality review audits of credentialing files
• Maintain up to date data for sales territory
• Track Oticon Medical’s licenses, certifications, and professional liability insurances to ensure timely renewals
• Maintains standards set forth by internal policies and procedures and local and federal regulatory requirements
• Coordinates with the insurance and field teams to stay ahead of pertinent insurances
• Interact with internal departments and varied levels of management, to accomplish credentialing timelines
• Meet or exceed departmental timeframes and quality metrics on a consistent basis
• Perform all other related duties as assigned

Qualifications:

• 3 years + experience in a credentialing role (DME, Audiology or Medical device background preferred)
• Ability to develop and manage credentialing independently
• A willingness to learn, take initiative and be resourceful
• A bias for action and pragmatic solutions
• Detail and results-oriented, ability to manage and prioritize requests, and effectively communicate
• The ability to be flexible in an ambiguous and dynamic environment
• Ability to solve problems, and establish trust
• Demonstrated skills in problem solving, analysis and resolution.
• Must be able to function independently, possess demonstrated flexibility in multiple project management capabilities.
• Must comply with HIPAA rules and regulations.
• Demonstrated, extensive knowledge of state licensing requirements, primary source verifications as well as credentialing database maintenance.
• Working knowledge of payer credentialing rules, portals and regulations preferred.
• CPCS Certification is a plus

The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

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