Credentialing Specialist

Description

Hematology Oncology Associates of CNY (HOACNY), voted one of Central New York’s Best Places to Work, is looking for a full time Credentialing Contract Analyst to join our professional team. HOACNY provides cancer care services, Monday through Friday. If you are a highly motivated, team oriented individual looking to make a difference in your career, please apply now.

Competitive salary ( rate based on experience) Bonuses/Stipends as well as a generous benefits package including medical, dental, life, std, ltd, 401k/pension, tuition reimbursement, convenient free parking, etc.

Credentialing Contract Analyst

Will be knowledgeable in and perform all aspects of insurer contract agreement and reimbursement negotiations, and practitioner insurance credentialing. Follows all contract negotiations and credentialing applications to completion. Reviews, analyzes and audits insurer reimbursement to identify trends or needed renegotiations. Maintains the national on-line CAQH Data Summary, as well as Medicare and Medicaid credentialing files for all providers. Maintains internal shared database files for insurer participation status and contact information, practitioner information, practitioner credentialing status and contracting and credentialing issues. Handles all inquiries regarding participation status and practitioner information. Works with outside contacts to resolve all contracting and credentialing issues/trends. Works as member of Coverage Analyst team.

Hematology Oncology Associates of CNY is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. HOA is also committed to compliance with all fair employment practices regarding citizenship and immigration status.

Requirements

Knowledge, Skills and

Abilities: Knowledge of the insurer health care industry, provider

relations and the credentialing processes. Knowledge of insurance contracts and fee schedules. Knowledge of Medicare LCD, FDA and NCCN guidelines. Skill in identifying, investigating and resolving problems. Ability to follow up all projects through to completion. Skill in computer applications, especially PC Word and Excel. Possess great attention to detail and organizational skills. Ability to maintain effective working relationships with patients, staff, insurers and the general public. Professional communication skills.

Education: High School Diploma

Experience: 5-years insurance and/or 2+ year credentialing