Amatus Health
Location
Owings Mills, MD | United States
Job description
The Credentialing Specialist is responsible for the timely and accurate submission of payer
enrollment for our providers across all our facilities. The position serves as the subject matter expert and leader of credentialing. The position exhibits a high attention to detail and communication with leadership of essential changes and required actions to ensure compliance across all states and federal requirements. They will uphold the policies and procedures of the RCM Team.
Qualifications:
• At least 1 year of experience in credentialing and/or
payer enrollment
• Proficient in MS Office products
• Strong collaboration skills with payers and internal
leaders
• Organizational and project management skills
• Detail oriented, able to independently manage process
and stakeholders
• Ability to multi-task and work in a fast paced, high
volume environment
Education:
High School Diploma or GED
Primary Role:
• Lead licensing and payer credentialing process across multiple states and payers
• Develop and maintain internal and external detailed databases of required state licenses, certifications, and
credentials of each provider in the Amatus Health Roster by facility.
• Set task reminders for continued follow up in advance of any term or expiring dates. The maintenance of the
provider roster would include identification and flagging of gaps or potential risks, monitoring and addressing of
relevant timelines associated with expirations/renewals (ensuring recertification occurs timely), and ensuring all
appropriate documentation is filed with appropriate entities
• Cross-Licensure Oversight: Partner with relevant vendors and/or providers to identify and manage key cross licensure opportunities as we grow and scale our clinician team. This includes serving as the project manager to
drive forward an internal process including communication with providers as well as regular reporting to the
Operations teams on licensure and credentialing statuses and timelines to align the launch and implementation of
new business
• Own relationship-management with relevant 3rd party partnerships including but not limited to licensure &
credentialing partners, state boards, and health plan payers. This may include providing necessary resources, and
deliverables to ensure effective management of the provider roster to mitigate any risks associated with growth
and expansion as well as to drive efficiencies in process
• Assist Human Resources in provider onboarding as it relates to primary source verification, initial credentialing,
and other key requirements to inform key decisions on hiring and onboarding. HR serves as the initial reviewer;
the Licensing Specialist is the final reviewer of the provider/applicant's licensing and medical credentialing
applications to ensure compliance with
At Amatus Health, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law. Amatus Health believes that diversity and inclusion among our team is critical to our success as a company, and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.
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