- Union Hospital Health Group (Terre Haute, IN)
- You belong at Union! The Payor Credentialing Specialist plays a key role in providing the highest quality of patient care while the patient is in at Union ... can we help? Call us at ### or email us at ###@union.health Payor Credentialing Specialist Details Essential Job Duties: + Credentialing /re-… more
- TEKsystems (Baltimore, MD)
- TeKsystems is currently hiring for a FULLY REMOTE Payor Credentialing Specialist ! MUST HAVE: 2+ years working for a payor in credentialing role ... accuracy, and timely processing of claims starting January 2026. Perform payor credentialing functions for applicable providers via electronic methods.… more
- Henry Ford Health System (Jackson, MI)
- …ensuring providers meet standards and regulations, processing Network credentialing applications, maintaining relationships between payors, clinics, and providers, ... verifying compliance with contractual obligations. The role performs further credentialing functions including resolving claims issues, assisting with onboarding new… more
- Caris Life Sciences (Irving, TX)
- …equivalent related environments. + Knowledge of health plan and governmental payor credentialing process and requirements, such as NCQA/state/federal standards, ... **Preferred Qualifications** + Bachelor's degree preferred. + Current Certified Provider Credentialing Specialist (CPCS) with the National Association of Medical… more
- Spectrum Billing Solutions (Skokie, IL)
- …is managed in the most efficient and streamlined manner. We are seeking to add a Credentialing Specialist to our growing team. If you are looking for a rewarding ... with strong communication and problem-solving skills. RCM Analyst | Revenue Cycle Credentialing Specialist | Insurance Specialist | Revenue Cycle… more
- WellSpan Health (York, PA)
- …leadership, training, or QA experience Preferred **Licenses:** + Certified Provider Credentialing Specialist Upon Hire Preferred or + Certified Professional ... + Quality Assurance and Reporting - Performs routine audits on credentialing and payor enrollment files to ensure compliance and accuracy. - Tracks audit… more
- Queen's Health System (Honolulu, HI)
- …status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, commercial payors, ... Medicare and Medicaid. * Performs credentialing in accordance with policies and procedures of The...state, insurance carriers, health plans and other third party payor requirements. II. TYPICAL PHYSICAL DEMANDS: * Essential: standing,… more
- TEKsystems (Addison, TX)
- Description The Provider Enrollment Specialist role focuses on managing the credentialing and enrollment for providers. The specialist will work closely with ... required 4 + years of enrollment experience Strong knowledge of medical credentialing and payer enrollment processes Strong attention to detail and accuracy… more
- RWJBarnabas Health (Livingston, NJ)
- …ACC + Ensure timely start date of new providers, working with HR, site credentialing and payor credentialing + Facilitate Provider enrollment in insurance/ ... Old Short Hills Road, Livingston, NJ 07039 Job Title: Specialist Location: Cooperman Barnabas Medical Ctr Department Name: Radiology...payors/ medical staff office credentialing by working with Practice Supervisor, Radiology Service Line,… more
- Banner Health (Phoenix, AZ)
- …care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services ... to achieve Magnet (TM) recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent...3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior… more
- HCA Healthcare (Plano, TX)
- …Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have an exciting opportunity for ... want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive patient interactions... is responsible for applying correct coding guidelines and payor requirements as it relates to researching, analyzing, and… more
- HCA Healthcare (Hendersonville, TN)
- …want to join an organization that invests in you as a Cash Post Review Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300 million in ... We are looking for a dedicated Cash Post Review Specialist like you to be a part of our...or other payment documentation. They also research and resolve payor -initiated recoupment requests. **In this role you will:** +… more
- HCA Healthcare (Austin, TX)
- …want to join an organization that invests in you as a Provider Enrollment Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... difference. We are looking for a dedicated Provider Enrollment Specialist like you to be a part of our...appropriate action to resolve + Appropriately resolve or escalate payor application denials + Meet and maintain established departmental… more
- HCA Healthcare (Nashville, TN)
- …may vary by location._** We are seeking an Inpatient Authorization Review Services Specialist for our team to ensure that we continue to provide all patients ... apply! **Job Summary and Qualifications** The Impatient Authorization Review Specialist will review post discharge, prebill accounts that do...will result in the account being denied by the payor that do not require a clinical review. Communicate… more
- PeaceHealth (Springfield, OR)
- …Basic Life Support Basic Life Support (BLS) **Skills** + Ability to meet payor credentialing requirements for pharmacist billing of clinic provided services. ... **Description** PeaceHealth is seeking a **Clinical Pharmacy Specialist Ambulatory for a Full Time, 1.00 FTE,...and + Preferred: Minimum of 3 years advanced pharmacotherapy specialist practice in an ambulatory clinical pharmacy setting with… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Billing Specialist is responsible for multiple components of the billing & coding process, including Accounts Receivable, Charge Entry, Edits ... resolves billing issues and provides recommendations. 14. Identifies and resolves credentialing issues for department physicians. 15. Meets with practice management,… more
- Select Medical (Tampa, FL)
- …front office personnel to identify the best fit and reduce Patient Service Specialist turnover. Ensure Checkster is complete for references. + Ensure all sections of ... the Patient Service Specialist On-Boarding process are complete to include the Front...+ Oversee and ensure completion of market-specific and state-specific credentialing of facilities and new and existing clinicians. +… more
- University of Colorado (Aurora, CO)
- …documentation according to established documentation timelines and in adherence with payor source(s) standards and clinic policy + Expected to demonstrate high ... substance use disorders, SUD subspecialty certification, and/or Certified Addiction Technician/ Specialist certification. + Experience working with population-based outcomes. +… more
- Nuvance Health (Danbury, CT)
- …for Denial Prevention department including absences, PTO, FMLA, etc. 6. Maintains credentialing /enrollment for Payor Portals sending letter out to vendors, ... Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring all… more