Medical Clinic Credentialer | ZR_26965_JOB

Job Description

This is a remote position.

Schedule : Part-time; 1PM to 5PM New York Time

Position Summary :

We are seeking a detail-oriented and experienced Medical Clinic Credentialer to join our team. The ideal candidate will play a key role in ensuring that our clinics are successfully credentialed and contracted with insurance payers. This individual will be responsible for navigating the credentialing and contracting process with precision, maintaining compliance with payer requirements, and facilitating favorable contract negotiations.

Key Responsibilities :

Credentialing

Manage and complete the credentialing process for providers and clinics with insurance companies.

• Maintain and update provider and clinic information in payer systems and internal databases.
• Ensure timely submission and follow-up of all required documents to meet payer deadlines.

Contracting

Facilitate the contracting process between the clinic and insurance payers.

Payer Relations

Serve as the primary liaison between the clinic and insurance payers during the credentialing and contracting process.

Compliance and Record-Keeping

Ensure compliance with federal, state, and payer-specific guidelines throughout the credentialing and contracting process.

Collaboration and Communication

Work closely with clinic leadership and other administrative staff to align credentialing and contracting activities with clinic objectives.

Requirements

Skills :

Strong understanding of insurance credentialing and contracting processes.

Technical Proficiency :

Familiarity with payer portals, credentialing software, and Microsoft Office Suite.

Benefits

Requirements

Experience : Minimum of 1-2 years in medical credentialing, contracting, or payer relations, preferably in a clinical setting. Skills : Strong understanding of insurance credentialing and contracting processes. Excellent negotiation and communication skills. Proficient in managing multiple tasks and meeting deadlines. Attention to detail and a high level of organization. Technical Proficiency : Familiarity with payer portals, credentialing software, and Microsoft Office Suite.