Credentialing Specialist (Finance)

We are a group of collaborative professionals specializing in acquiring and streamlining eyecare practices, and we are currently looking for a highly motivated, detail-oriented Credentialing Specialist to lead our organizations contracting and credentialing needs with both vision and medical insurance providers.
Job Summary
Reporting to the Director of Revenue Cycle Management, the Credentialing Specialist evaluates, analyzes, and coordinates all aspects of contracting and credentialing with both Vision and Medical panels. and maintain all areas related to the provider enrollment process for Optometrists practicing within the InFocus Eyecare entities. The Credentialing Specialist provides integral support to healthcare operations by ensuring timely onboarding of healthcare providers.
Duties Include (But Not Limited To):
Facilitate onboarding of new Optometrists as it relates to credentialing. Becoming a subject matter expert of the InFocus Corporate structure and entity assignment Creation of NPIs for entities and locations Maintains COIs for entities and providers Up-to-date maintenance of all CAQH, PECOS profiles Initiate new contracting with insurance providers Complete and process all contracts and credentialing enrollment from inception for both vision and medical providers in a timely manner. Process recredentialing where necessary Maintains clear and detailed reporting to leaders of the company on all aspects/duties/progress related to the position with limited follow-up or supervision.
Position Qualifications and Requirements
Education: High School Diploma (preferably Associates degree) Experience: Minimum of 2 years of credentialing experience required in a healthcare setting with prior experience in any of the following: practitioner insurance enrollment, medical staff (hospital) or vision insurance credentialing. Medical credentialing processes, policies, and procedures. Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis. CPCS, CPMSM, or PESC certification preferred. Clear understanding of omittance with dispensing models as it pertains to vision contracting Demonstrates full knowledge of EDI, EFT enrollment processes as it pertains to contracting Ability to communicate effectively both orally and in writing. Customer service skills. Maintain high levels of organization while being extremely focused on detail Ability to respond to emails timely and effectively. Ability to use independent judgment and to manage and impart confidential information. Ability to maintain confidentiality and discretion in all communications on behalf of credentialing applicants and/or applications. Ability to make administrative/procedural decisions and judgments. Advanced skills in computerized spread sheeting and database management with a working knowledge of Excel, Word and Adobe PDF Creator Ability to learn new applications to function effectively. Skill in establishing priorities with independent coordination of day-to-day aspects.
Special Requirements/Skills
Experience in contacting and credentialing with Vision Payors is preferred. Experience in contracting and credentialing with Medicare and Medicaid is preferred. Experience with Microsoft Office suite is preferred. Telehealth credentialing experience is a plus. Bilingual in English and Spanish is a plus.
Must be comfortable in a fast-paced, dynamic environment and have the ability and willingness to reprioritize on short notice and work on multiple simultaneous projects. Flexible and able to work with various personalities and enjoys working with a team. Time management skills required. The ability to meet deadlines in a challenging environment is essential. High level of adaptability and willingness to embrace change in a fast-paced, sometimes challenging atmosphere while maintaining a courteous and professional demeanor.