WFH Insurance Credentialing Specialist

2 days ago

Manila, National Capital Region, Philippines BruntWork Full time
Job Description

This is a remote position.

Reminder

  • Kindly apply directly to the link provided; you will be redirected to BruntWork's Career Site. Complete the initial requirements, including the voice recording, pre-screening assessment, and technical check of your computer/device.

Job Highlights:

  • Contract type: Independent Contractor
  • Night Shift Schedule: Monday to Thursday - 8:45am to 5pm New York Time (8:45pm - 5am Manila Time)
  • Friday - 8:45am to 3:45pm New York Time (8:45pm - 3:45am Manila Time)

Will assist the provider enrollment team members to meet their responsibilities to maintain active status to all providers as required by insurance carriers, network management, and state Medicaid regulations.

Responsibilities:

  • Maintain individual providers with up-to-date information needed to complete credentialing by the state and govt rules.
  • Maintain the provider information in various systems utilized by different practice groups.
  • Ensure appropriate log-ins are available.
  • Update each provider's database in a timely fashion and according to the carrier's schedule.
  • Complete revalidation requests by payers and carriers.
  • Stay on top of near expiring licensing certificates and/or liability insurance information.
  • Complete credentialing applications for providers with commercial payers and Medicaid.
  • Complete re-credentialing for commercial payers and Medicaid.
  • Work closely with the other teams to identify and resolve denials and authorizations in claims related to credentialing.
  • Follow up on status and open escalation tickets for submitted or denied credentialing applications.
  • Prepare email communication with relevant information to be sent to practice groups by the provider enrollment rep.
  • Attend daily meetings with provider enrollment member.
  • Attend weekly team meetings, completing the to-do's assigned to provider enrollment member.
  • Other duties as assigned
Requirements

Knowledge/skills/abilities:

  • Detail orientated with above-average organizational skills
  • Able to plan and prioritize to meet deadlines
  • Excellent verbal and written communication
  • Communicates clearly and effectively
  • Excellent reading comprehension
  • Excellent computer skills, including Microsoft programs such as Excel, Word
  • Thorough understanding of navigating the internet

Education/experience required:

  • At least 2 years in college
  • Two years experience in US-based medical billing practice or
  • Two years experience in a medical practice dealing with billing including but not limited to, provider credentialing, authorizations, reimbursement, etc. preferably in Behavioral Health to some degree

MBH Core Values: We hire/fire/promote based on these core values + job-specific performance:

  1. Respectful of our unique cultural environment
  2. Absolute Confidentiality
  3. Embracing Teamwork
  4. Loyal Behavior & Positive Attitude
  5. Accountability
  6. Proactiveness
  7. Thoroughness
  8. Focused on results
  9. Inspired to learn & grow constantly
  10. Devoted to providing top-tier services to our clients through the "Unique Service Oriented Philosophies"
Benefits

Independent Contractor Perks

  • Permanent work from home
  • Immediate hiring
  • Steady freelance job
  • Profit sharing incentive
  • Paid time off
  • Holiday pay
  • Annual Performance and Raise Evaluation
  • Quarterly Perfect Attendance Incentive
  • HMO
  • BruntWork Loan Assistance

Please note that since this is a permanent work-from-home position and an "Independent Contractor" arrangement, the candidates must have their own computer and internet connection. They will handle their own benefits and taxes. The professional are on hourly rates and the rate depends on your performance in the application process.

ZR_28916_JOB

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