Payor/ Credentialing Specialist
Kane County Hospital
- Kanab, Utah, United States
- Kanab, Utah, United States
About
Complete and submit provider credentialing and recredentialing applications. Maintain accurate provider records in credentialing databases and CAQH. Monitor credential expiration dates, licenses, certifications, malpractice insurance, and other required documents. Follow up with insurance companies regarding application status and approvals. Coordinate provider enrollment with Medicare, Medicaid, and commercial payors. Ensure compliance with federal, state, and organizational credentialing requirements. Update provider information with payors as needed. Resolve credentialing-related claim denials and enrollment issues. Maintain organized electronic and paper credentialing files. Communicate effectively with providers, office staff, and insurance representatives. Prepare reports on credentialing status and outstanding items. Qualifications
High school diploma or equivalent required; associate degree preferred. Previous experience in healthcare credentialing, medical billing, or provider enrollment preferred. Knowledge of CAQH, PECOS, Medicare, Medicaid, and commercial insurance processes. Strong attention to detail and organizational skills. Proficiency with Microsoft Office and credentialing software systems. Ability to manage multiple deadlines and work independently. Excellent written and verbal communication skills. Preferred Skills
Experience with physician or behavioral health credentialing. Familiarity with HIPAA and healthcare compliance standards. Ability to troubleshoot enrollment and billing issues efficiently. Schedule
Part-time position (approximately 20-30 hours per week). Flexible schedule may be available depending on organizational needs. RequirementsHigh school diploma or equivalent required; associate degree preferred. Previous experience in healthcare credentialing, medical billing, or provider enrollment preferred. Knowledge of CAQH, PECOS, Medicare, Medicaid, and commercial insurance processes. Strong attention to detail and organizational skills. Proficiency with Microsoft Office and credentialing software systems. Ability to manage multiple deadlines and work independently. Excellent written and verbal communication skills. Preferred Skills
Experience with physician or behavioral health credentialing. Familiarity with HIPAA and healthcare compliance standards. Ability to troubleshoot enrollment and billing issues efficiently.
Languages
- English
Notice for Users
This job comes from a TieTalent partner platform. Click "Apply Now" to submit your application directly on their site.