Provider Credentialing Specialist II

Description

SUMMARY

At ZoomCare we are working hard to make healthcare easy.  Our mission is to deliver innovative, high-quality, convenient healthcare when patients need it. We offer same-day, no-wait visits in urgent care, primary care, and specialty care and we’re expanding from our roots in the Pacific Northwest to new markets.  We hope you will apply to become part of our dedicated, fast-moving team of superstars!

ZoomCare is seeking a Credentialing Specialist II to join our team!   

The Credentialing Specialist II is responsible for providing support to the Credentialing Team and works to support the goals of the Billing Department. The Specialist II assists in performing all credentialing and recredentialing activities. This role ensures that all ZoomCare’s new and existing provider’s files are maintained and continually kept up to date.  

SCHEDULE AND TRAINING 

• Location: Remote (Oregon OR Washington) 
• Schedule: Mon-Fr 8:00am-5:00pm 
• Depending on the position and associated requirements, there may be additional mandatory training requirements that are outside of your scheduled shift. 

ESSENTIAL FUNCTIONS 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Represent our values: Awesome, Creative, Respectful, Team Players, Get it Done.
• Manage credentialing and re-credentialing activities to ensure all ZoomCare provider files, both new and existing, are accurate and up to date.
• Maintain credentialing files, ensuring all licenses and certificates are current and completed on time with thorough follow-up.
• Review provider credentialing applications, including new applicant credentialing, re-credentialing, and ongoing maintenance of credentials.
• Monitor, track, and report credentialing information on a daily, weekly, and monthly basis.
• Follow up with providers and insurance to ensure all credentialing applications are received, processed, and files are accurate and current.
• Enroll providers in Medicare using the Medicare Identity and Access System and PECOS.
• Deliver excellent customer service by communicating effectively with the team, solving problems, and organizing projects.
• Analyze data with strong attention to detail and accuracy, prioritizing tasks to work efficiently.
• Other duties as assigned.

QUALIFICATIONS

• High school diploma or GED equivalent, required. 
• Bachelor’s degree in finance, accounting, business administration, or a related field, or an equivalent combination of education and experience, preferred. 
• Prior experience in credentialing, provider licensing, or privileging.
• Prior experience in Medicare provider enrollment
• Advanced understanding of NCQA Standards.
• Advanced knowledge of provider licensing processes with regulatory agencies.
• Able to effectively communicate both verbally and in writing.
• Proficient in Adobe, Google Suite, Microsoft Office Suite, Slack or related software and an ability to quickly learn new technology systems.

 COMPENSATION PACKAGE

• Medical, Dental, Vision benefits
• 401K with employer match
• Paid Time Off, Paid Holidays, Paid Parental Leave, Sabbatical Program
• Hourly Range: $27.00 - $31.50/hr
• Other Compensation: May be eligible for other compensation such as bonuses

WORKING CONDITIONS 

• Prolonged periods of sitting and/or standing at a desk and working on a computer.
• Project timelines and work volume / deadlines may often require more than your scheduled hours per week or work outside of regular business hours to complete essential duties of this job.
• Occasional reaching and lifting of small objects and operating office equipment.
• Ability to adjust focus between close and distance vision.
• This position requires remote work and being able to collaborate with teams to accomplish assigned tasks. 
• Exposure to sensitive and confidential information.
• Must wear a mask as needed  

 ZoomCare is committed to the safety and wellbeing of our employees and patients. Therefore, we require that patient-facing employees receive all required vaccinations, including, but not limited to, Hepatitis B., MMR, PPD, Varicella (Chickenpox), TD/TDAP, and all employees to receive COVID-19 as a condition of employment. Medical and religious exemptions or reasonable accommodations may apply.