Description Credentialing Specialist-Exact Billing Solutions Lauderdale Lakes, FL About Exact Billing Solutions
Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental health, and autism fields of healthcare services.
We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation.
With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies.
Growth Opportunity
If you're an experienced healthcare credentialing professional looking for a unique opportunity with a rapidly growing company, this could be a turning point in your career.
Our Credentialing and Contracting Specialist plays a crucial role in ensuring that healthcare professionals within an organization meet all necessary qualifications, certifications, and regulatory requirements.
This position involves overseeing the credentialing process for medical staff, managing a team of credentialing specialists, and collaborating with various departments to maintain compliance and uphold the highest standards of quality and patient safety.
What You'll Do Credentialing Process Management: Oversee the end-to-end credentialing process for medical staff, including physicians, nurses, allied health professionals, and other relevant personnel. Develop and implement efficient credentialing workflows, ensuring accuracy and adherence to established protocols. Review and evaluate credentialing applications, verifying information, licenses, certifications, references, and other pertinent documentation. Stay current with industry regulations, standards, and best practices related to credentialing and privileging. Ensure that all credentialing activities are in line with federal, state, and local regulations, as well as accrediting bodies' requirements. Database Management: Use credentialing software and databases to maintain accurate records of medical-staff credentials, licensures, certifications, prefilling insurance applications, tracking progress, and other relevant information. Generate reports and analytics to track and monitor contracting and credentialing processes and compliance metrics. Requirements Education/Experience and Other Requirements Several years of experience in healthcare credentialing. In-depth knowledge of credentialing processes, regulatory requirements, and healthcare industry standards. Must maintain clean background/drug screenings and driving record. Expertise Needed Strong collaboration skills for working with other departments, such as Human Resources, Legal, Admissions, and Compliance.Thorough understanding of medical terminology, licensing, and certifications across various specialties. Excellent organizational skills with a keen attention to detail. Proficiency in using credentialing software and databases. Exceptional communication and interpersonal skills. Problem-solving abilities and the capacity to work well under pressure.