Profile and Credentialing Representative

Profile and Credentialing Representative  

We are currently seeking a full time Profile and Credentialing Representative to join our team.

Job Summary:

This position is responsible for taking the data provided to their department and using it to compile, record, and communicate necessary information to our clients, insurance companies, as well as other departments. Making sure that all necessary information is communicated to the appropriate party in a timely fashion is imperative. Day-to-day responsibilities may vary.

Job Duties and Responsibilities:

Core duties and responsibilities include but are not limited to the following. Other duties may be assigned as necessary.

  • Establish and maintain positive and effective communication with clients to ensure proper set up of their account.
  • Oversee and process all new clients throughout the entire onboarding process.
  • Establish and maintain positive and effective communication with various departments in order to ensure proper processing and set up of all client accounts.
  • Work with insurance companies to properly set up clients including insurance log ins, ERAs, EFTs, electronic processing of claims, etc.
  • Answer any and all client questions in a professional an efficient manner.
  • Request and obtain patient pertinent health information.
  • Detailed system documentation of accounts.
  • Communicating with other departments to obtain or provide needed information on an account.
  • Special Projects as needed.

Required Education and Experience:

  • 2+ years administrative experience in medical facility or related field.
  • 2+ years of experience in Customer Service or related environment preferred.
  • High school diploma or GED equivalent

Required Knowledge, Skills, and Abilities:

  • Knowledge of CPT, ICD 9 & ICD 10 coding, medical terminology, and EMR Systems.
  • Proficiency in Microsoft Office Applications including Excel, PowerPoint, and Word.
  • Knowledge of HIPAA regulations and guidelines.
  • Must be organized, detail oriented, and have the ability to multitask.
  • Excellent verbal and written communication skills.
  • Critical thinking and problem solving skills.
  • Must be able to work in a team environment.
  • Behavioral health knowledge is a plus.

Compensation and Benefits:

  • Competitive market-based salary, salary commensurate with experience.
  • Benefits package available.

How To Apply:

Email resume with salary history and a cover letter to be considered.