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Contracting & Credentialing Specialist I at Experity, Inc in Springfield, Missouri

Posted in Admin - Clerical 30+ days ago.

Type: Full-Time





Job Description:

Experity is the leading software and services company for on-demand healthcare in the U.S. urgent care market, providing an integrated operating system complete with electronic medical record (EMR), practice management, patient engagement, billing, teleradiology, business intelligence and consulting solutions. Nearly 50% of the U.S. urgent care market runs on Experity solutions.  With Experity, providers can best meet the demands of the evolving on-demand space and deliver high-quality, high-velocity care by streamlining operations, improving patient experiences and optimizing revenue.


Experity Unveils New Urgent Care EMR/PM Designed to Power the Future of On-Demand Care


In addition to medical, dental and vision benefits Experity offers:



  • Quarterly bonuses 

  • Flexible schedules

  • Gym reimbursements

  • Fun company events throughout the year (summer picnic, Christmas party and more!)

  • Team building

  • 401K company match

  • Experity Synthetic Equity Program (ESEP)

  • Paid time off

  • Volunteer paid time off

Hybrid/remote workforce:


This positions is eligible to work remotely or a hybrid of remote and in the office.  


Position details:


The Contracting and Credentialing Specialist I duties include research of credentialing requirements, completion of network participation and provider enrollment applications, creation of reports, document management, and direct client support. They are responsible for following outlined regulations, policies and procedures regarding CC processes.


Responsibilities:



  • Build and maintain professional relationships with team members as well as with other departments, clients and payer representatives

  • Maintain confidential client, provider and company information at all times

  • Understand and perform the essential elements of the complete CC process including, but not limited to:

  • Basic information regarding various payer types (commercial and government)

  • Basic information pertaining to relevant provider types (M,D., D. O., NP, and PA) and the credentials and specialty options for each

  • CAQH profiles/updates

  • Following the Standard Operating Procedures developed internally and by each payor for compliance

  • Network access processes (Letter of Interest, applications, submission of documents, etc…)

  • Collection of crucial information from payor in terms of CC requirements and process by payer/market/contract type

  • Collections and recoding of relevant provider and client level information

  • Records all process, steps and results in CC software

  • Meets regularly with Lead or Team lead to provide necessary updates

  • Participate in staff interviews

  • Perform job duties in accordance with the productivity and quality standards as defined by Experity

  • Other duties as assigned

Education and Experience:



  • A high school diploma or equivalent

  • A minimum of one year experience in Customer service

  • Proficiency in Windows based applications and MS Office software products

Preferred:



  • Associate’s degree in business or equivalent combination of education and experience

  • Experience in medical office type setting

  • Some knowledge of medical insurance terminology

  • Experience or training Credentialing application completion

  • Credentialing Software, PECOS, CAQH, and other enrollment portals

  • Certification in healthcare billing or healthcare field experience

Every team member exhibits our core values:



  • Team First

  • Lift Others Up

  • Share Openly

  • Set and Crush Goals

  • Delight the Client

 


 

See job description





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