PedsOne Hiring for Credentialing Specialist at Remote Full Time

Opportunity

Twice voted among the ‘Best Places to Work’ in Vermont, and a member of Vermont Businesses for Social Responsibility, PedsOne is a small company with big benefits, growing every year, and intent on being the best at what we do. We are dedicated to providing unsurpassed services for pediatricians so they can focus on patient care. Our guiding motto is Better Billing for Doctors, Brighter Futures for Kids. PedsOne is a values-driven company that offers a team-oriented culture and merit-based compensation, and our employees are at the heart of what we do.

Job Summary

The Credentialing Specialist (CS) supports our pediatric practice clients by enrolling their new providers with payors, and our billing team by serving as an internal resource for all credentialing-related billing matters.

Responsibilities

Manage payor enrollment for new providers with new and established clients

Ensure that each new provider’s CAQH is complete

Actively communicate with practice managers on the status of the credentialing/enrollment process

Maintain professional relationships with all payors or IPAs to ensure that credentialing is completed within a timely manner

Create an internal provider database with pertinent credentialing-related information

Field questions about contracts and credentialing and how they relate to billing

Stay current with industry changes and update Account Managers accordingly through communication and training

Work closely with Account Managers and billing team for credential-related denials and issues

Provide assistance with other assigned tasks when/as workload permits

Minimum Requirements

• 4 years of combined experience in relevant healthcare administration (credentialing, billing, compliance);at least 2 of these years specifically focused on payor enrollment.
• Knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures and documentation
• Ability to research and and stay current with credentialing requirements with each payer
• Ability to use independent judgment, and to manage and communicate confidential information
• Demonstrated comfort with computer technology
• Established proficiency in or ability to quickly become proficient in the Google Workspace (G-Suite): Gmail, Google Drive, Docs, Sheets, etc.
• Demonstrated ability to prioritize, organize and track time-sensitive projects
• Strong attention to detail, organization and follow through

Desired Skills & Attributes

• Self-motivated and eager to learn
• Ability to prioritize and multitask
• Thrives in an autonomous work situation
• Prior remote work experience (for a remote position)

Requirements for Remote Employment

• A private, dedicated space to ensure HIPAA compliance
• Sufficiently high speed and reliable internet service to perform the job. Download speed: optimal 10-20 mbps. Upload speed: over 5 mbps. Latency: under 50 is ideal. (Anything above 100 ms will not work.) A speed test for these metrics is available at https://speedof.me/

We are recruiting staff for both remote and onsite positions. Candidates in Vermont within a reasonable commuting distance from our office in Winooski are invited to apply for a hybrid position (3 days in office, 2 days remote).

Benefits

Health, vision, dental and short-term disability insurance

CTO accrued from the 1st day of employment

6 paid holidays with 5 additional paid days

3 paid days for personal emergency

Employee retirement account with 3% matching

Paid parental leave

Employee Assistance Program

Application Instruction

Include a resume and cover letter highlighting your experience and qualifications. PLEASE NOTE: We will only review and respond to applicants who have completed the assessments associated with this posting.

This Company Describes Its Culture as:

• Outcome-oriented — results-focused with strong performance culture
• Team-oriented — cooperative and collaborative

Work Remotely

• Yes

This Job Is Ideal for Someone Who Is:

• Dependable — more reliable than spontaneous
• Detail-oriented — would rather focus on the details of work than the bigger picture
• Autonomous/Independent — enjoys working with little direction

Job Type: Full-time

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

COVID-19 considerations:
We are OSHA compliant and adhering to state and federal guidelines for the safety and wellbeing of our staff.

Experience:

• Healthcare: 4 years (Required)
• Payor Enrollment: 2 years (Required)

Work Location: Remote