Spectrum Billing Solutions logo
Spectrum Billing Solutions

Billing Solutions That Work

Credentialing Team Lead

GeneralGeneralFull TimeRemoteSeniorTeam 51-200H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

3 days ago

Salary

0

Seniority

Senior

5 yrs expEnglish

Job Description

Credentialing Team Lead

Spectrum Billing Solutions

• Complete provider credentialing and contract applications with third-party carriers and government health plans • Review provider credentialing and contracting information to ensure completeness and accuracy • Monitor applications and follow-up in a timely manner • Document, maintain and crosscheck client credentials in multiple databases, including CAQH and other third-party databases, as applicable • Create, update and track provider information in the internal credentialing system to ensure that credentials are completed timely and correctly • Research new state and payer information and guidelines • Serve as a go-to person for credentialing team • Assist with escalated credentialing matters • Meet or exceed required timeframes for provider communications, enrollments, and follow-ups • Maintain quality working relationships with internal and external customers

Job Requirements

  • 3-5 years of experience in credentialing and contracting
  • Knowledge of Commercial Insurance and Government Payor guidelines
  • Ability to plan, organize, and complete work with competing priorities
  • Takes accountability for personal productivity and quality of output
  • Organized and detail-oriented with strong communication and problem-solving skills

Benefits

  • A close-knit team of talented and skilled individuals
  • Growth opportunities within the organization
  • Competitive salary
  • Healthcare benefits including medical, dental & vision, 401K
  • Flexible PTO

Related Categories

Related Job Pages

More General Jobs

Ntiva, Inc. logo

Service Desk Technician I

Ntiva, Inc.

Managed IT, cybersecurity, and cloud services built to help organizations grow.

General3 days ago
Full TimeRemoteTeam 501-1,000Since 2004H1B No Sponsor

• Accept incoming client troubleshooting calls and make outbound calls in response to email requests • Engage with clients via email, providing clear and prompt communication • Leverage your Windows proficiency, network skills and knowledge of inter-connectivity with servers and printers to prepare and set up laptops and desktops • Conduct basic client account administration in Office 365 and Active Directory • Track scheduled work, proactively communicating changes to all stakeholders, and promptly updating both the schedule and clients as needed • Log detailed case notes in Ntiva's ticketing system and other documentation platforms, ensuring clear and accurate records • Assess the need for documentation updates and inform management of any necessary changes • Maintain a positive and client-centric focus throughout all interactions, fostering trust and building strong client relationships • Maintain meticulous attention to detail to uphold accuracy and efficiency standards

Illinois
$39K - $48K / year
Northwestern Medicine logo

Patient Access Specialist

Northwestern Medicine

What makes us better, makes you better.

General3 days ago
Full TimeRemoteTeam 10,001+H1B No Sponsor

• Consistently practices Patients First philosophy and adheres to high standards of customer service • Responds to questions and concerns • Forwards, directs, and notifies Team Lead or Operations Coordinator of extraordinary issues as necessary • Maintains patient confidentiality per HIPAA regulations • Provides exceptional customer service to patients which establish a positive first impression of Northwestern Medicine • Exceeds all consumer requests and alerts management of issues or concerns that require escalation • Correctly identifies and collects patient demographic information in accordance with organization standards • Interacts with various hospital departments and physicians offices to effectively schedule and direct patients through the NMHC systems in a patient/customer friendly manner • Reaches out to patients to schedule an appointment as defined • Performs medical necessity checks as necessary for scheduled services • Completes out-of-pocket estimations as requested by patients • Provides training and education as needed • Manages work schedule efficiently, completing tasks and assignments on time • Participates in Quality Assurance reviews to ensure integrity of patient data information • Uses effective service recovery skills to solve problems or service breakdowns when they occur • Utilizes department and hospital policies and procedures to complete assigned tasks • Communicates information to patients regarding questions about physician referrals, insurance referrals, and consultations • Provides professional and constructive environment for communication across units/departments and resolves operational issues.

Illinois
$18 - $27 / hour
Northwestern Medicine logo

Patient Access Specialist

Northwestern Medicine

What makes us better, makes you better.

General3 days ago
Full TimeRemoteTeam 10,001+H1B No Sponsor

• Consistently practices Patients First philosophy and adheres to high standards of customer service • Responds to questions and concerns • Maintains patient confidentiality per HIPAA regulations • Provides exceptional customer service to patients • Exceeds all consumer requests and alerts management of issues or concerns • Correctly identifies and collects patient demographic information • Interacts with various hospital departments and physicians offices to effectively schedule and direct patients • Performs medical necessity checks as necessary • Informs patients of any issues with securing their encounter • Completes out-of-pocket estimations as requested by patients

Illinois + 3 moreAll locations: Illinois | Iowa | Missouri | Wisconsin
$18 - $27 / hour
Northwestern Medicine logo

IS Team Lead, Epic HB/PB

Northwestern Medicine

What makes us better, makes you better.

General3 days ago
Full TimeRemoteTeam 10,001+H1B No Sponsor

• Management of all types of information systems projects • Prepare project plans, accurately estimates project timeframes and resource requirements • Identify required skill sets, obtain project and resource allocation approvals and assign project tasks ensuring both successful task completion and staff development • Produce project status reports • Manage the project team, including clients, vendors, consultants, and IS staff • Responsible for working with project teams to ensure that established design and quality standards are maintained • Review project team techniques and ensure that IS guidelines are followed for system and integration testing

Iceland
$49 - $69 / hour