BerryDunn

Credentialing Specialist - Per Diem

Job Locations US-Remote | US-CT-Hamden
ID
2022-2347
Category
Compliance and Credentialing
Type
Per diem

Overview

BerryDunn is seeking a per diem Credentialing Specialist to join our Healthcare Compliance and Credentialing Practice Area. Under the supervision of the Credentialing leadership team, the Credentialing Specialist will be responsible for all aspects of credentialing/re-credentialing providers, including, but not limited to, verification of application/documents, submission of requests for consideration, initial and revalidation applications, approval, denial, termination letters, primary source verification (PSV) activities, and accurately loading provider information into the Credentialing database.  The Credentialing Specialist works closely with the Credentialing leadership on servicing the client needs and meeting contractual obligations. The Credentialing Specialist will need to be available to provide support to clients and the team during the business day; evening and weekend hours may be requested or required as client and project needs arise.  This position is planned to sit in our New Haven office location or remotely.

Responsibilities

You Will:

  • Complete credentialing and/or re-credentialing applications for physicians, ancillary providers and facilities or groups with third-party payers and governmental programs (Medicare and Medicaid) as requested by the client in an accurate and timely manner
  • Perform Primary Source Verification (PSV) services including but not limited to verification of licenses, malpractice and work history; perform PSV file audits as requested.
  • Complete, update and maintain Council for Affordable Quality Healthcare (“CAQH”) profiles for providers
  • Maintain a Credentialing database in accordance with BerryDunn’s policies and procedures for all participating and non-participating providers with payer identification numbers and effective dates 
  • Partner with client liaisons, including billing departments to update the enrollment status of the providers
  • Contact payers to follow up on submitted applications within BerryDunn’s policies
  • Respond to various inquiries and requests for information from participating physicians, staff, hospitals, and managed care companies timely and with professionalism
  • Communicate with providers or their designees to obtain requisite credentialing information to facilitate timely completion and submission of required documents
  • Update client regularly on process and communicate any delays
  • Continuously inform Credentialing leadership of the project status and assist in managing expectations related to deliverables and deadlines
  • Be responsible for timely and accurately accounting of hours (billable and non-billable) in time and attendance software for proper billing of services rendered

Qualifications

You Have:

  • High school education required, bachelor’s degree preferred
  • 2-3 years of relevant healthcare experience is required including specialized skills in Credentialing and/or Medical Billing
  • Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Staff Service Management (CPMSM) certification a plus
  • Ability to work independently, as well as, in a team setting
  • Exceptional organization and time management skills to manage priorities and deadlines
  • Effective verbal, interpersonal, and written skills
  • Strong attention to detail and quality
  • Proficiency with Microsoft Office suite (Word, Outlook, Teams ) and Adobe; Excel preferred

About BerryDunn:

BerryDunn is a CPA and Management Consulting firm with over 800 employees throughout the country that provide a full range of services including Management and IT Consulting, Health Analytics/Actuarial Consulting, Audit, Accounting, and Tax. We are headquartered in Portland, Maine, with offices in Arizona, Connecticut, Massachusetts, New Hampshire, and West Virginia. BerryDunn has maintained steady growth over its 40+ year history, and the firm is regularly named to national “Top 100” lists, including recent recognition for being a “fastest-growing” firm. We partner with clients across the United States and Canada, and we attribute our growth to attracting, developing, and retaining outstanding employees who help our clients create, grow, and protect value. 

 

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.

 

 

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