Credentialing Specialist Job at Gastro Health, Miami, FL

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  • Gastro Health
  • Miami, FL

Job Description

Gastro Health is seeking a Full-Time Credentialing Specialist  to join our team!

Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours.

This role offers:

  • A great work/life balance
  • No weekends or evenings – Monday thru Friday
  • Paid holidays and paid time off
  • Rapidity growing team with opportunities for advancement
  • Competitive compensation
  • Benefits package

Duties you will be responsible for:

  • This role is geared towards payer enrollment, however, candidates should be able to understand and complete all roles in the Credentialing Department related to provider management:
    • Onboarding
      • Working with providers and offices to obtain complete records from new providers.
    • Verifying data and interpreting results
    • Data entry and file setup
    • Timely processing and presentation for approval
    • Enrollment
      • Completing third party applications for payers, facilities, malpractice insurance etc.
    • Working effectively and professionally with providers and contacts to follow the process through approval
    • Maintenance
      • Keeping providers records up to date and current with internal standards
    • Responding to payer and facility requests for re-processing applications on schedule
    • Running reports on and renewing all credentials/Expirables such as licenses, DEAs, CPR certificates etc
    • Educating providers and offices on processes and assisting in issue resolution
    • Intake and appropriate processing of requests from all external and internal parties
    • Responding and assisting in the resolution of billing and claims issues
    • Making sure external sources are updated regularly such as CAQH, NPI etc
    • Must establish and maintain a strong working relationship with company staff, providers, third-party payers and all other entities.
    • Participate in delegated credentialing activities as may differ from the above tasks
    • Support the Credentialing department with special projects as the needs arise
    • Other duties as assigned

Minimum requirements:

  • CPCS desired
  • 3+ years' experience in Credentialing

We offer a comprehensive benefits package to our eligible employees:

  • 401(k) retirement plans with employer Safe Harbor Non-Elective Contributions of 3%
  • Discretionary profit-sharing contributions of up to 4%
  • Health insurance
  • Employer contributions to HSAs and HRAs
  • Dental insurance
  • Vision insurance
  • Flexible spending accounts
  • Voluntary life insurance
  • Voluntary disability insurance
  • Accident insurance
  • Hospital indemnity insurance
  • Critical illness insurance
  • Identity theft insurance
  • Legal insurance
  • Pet insurance
  • Paid time off
  • Discounts at local fitness clubs
  • Discounts at AT&T

Additionally, Gastro Health participates in a program called Tickets at Work that provides discounts on concerts, travel, movies, and more.

Gastro Health is the one of the largest gastroenterology multi-specialty groups in the United States, with over 130+ locations throughout the country. Our team is composed of the finest gastroenterologists, pediatric gastroenterologists, colorectal surgeons, and allied health professionals. We are always looking for individuals that share our mission to provide outstanding medical care and an exceptional healthcare experience. We offer a comprehensive benefits package to our eligible employees.

Gastro Health is proud to be an Equal Opportunity Employer. We do not discriminate based on race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender

identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

We thank you for your interest in joining our growing Gastro Health team!

Job Tags

Full time, Local area, Flexible hours, Afternoon shift, Monday to Friday,

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