Scottsdale, Arizona
Managed Care Credentialing Specialist Job Opening in Scottsdale, Arizona - Passport Health is looking for an experienced, motivated, results-driven professional to initiate, coordinate and maintain health insurance payor contracts in multiple states. The Managed Care Credentialing Specialist will drive the growth of company?s payor network by:
ESSENTIAL DUTIES AND RESPONSIBILITIES
*Responsible for negotiating and procuring contracts from insurance providers
* Accountable for application management reports and updating the system to reflect all prospect interaction and coordinates activities as necessary within the firm
* Reconcile contracts and supporting documents to database
*Manage CAQH information
* Perform online provider/facility research to include websites and contacting offices to confirm information, including contact and follow-up for missing information
*Establish and maintain a professional relationship with our insurance contacts
* Develop and implement standards to ensure the accuracy of credentialing data in the credentialing system as well the credentialing data required by healthcare entities that have delegated credentialing to the network
* Performs fee schedule analysis for both newly proposed and existing insurance fee schedules. Monitors and tracks insurance contracting rates.
*Assist billing team with any contract issues
* Uses team approach to resolve provider contract language and fee schedule negotiations
* Must successfully meet productivity targets
* Proven ability to work both independently and as part of a team
QUALIFICATIONS
* Possess strong customer focus, team leadership and a proactive problem solving approach
* Excellent written and oral communication skills
* Interpersonal skills with a proactive communication style
* Must have strong working knowledge of Microsoft Office applications (Excel, Word, Outlook)
* Must be well organized and capable of working independently on a variety of assignments specific, but not limited to managed care contracting
* Performance in jobs held characterized by strong customer focus, proactive, open and honest communication style
EDUCATION AND EXPERIENCE
*Bachelor's Degree. Healthcare related degree preferred
*Minimum 1-3 years credentialing experience soliciting and negotiating payor contracts
*Sales experience, good presentation and public speaking skills
Job Type: Full-time
Required education:
Bachelor's
Required experience:
Medical Credentialing: 3 years
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