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Credentialing Specialist

Bloomington, IL, USA Req #243
Tuesday, October 13, 2020

ARE YOU READY TO BE A PART OF A GROWING TEAM AND SHARE THE PASSION FOR WHAT YOU DO?

 
Keplr Vision is a business support services company focused on investing and partnering with medically focused optometry practices and providing best in class lens technology and patient experience. Keplr currently has over 150 practices in 29 states and is able to provide exceptional levels of clinical, operational and marketing support with its more than decade-old business services platform.


Keplr Vision is currently going through tremendous growth and expanding its Revenue Department. We are seeking a motivated, detail-oriented Credentialing Specialist to join the team in our Bloomington, IL location!  We are looking for a results driven, detailed oriented individual who has the ability to work independently.  The credentialing specialist develops and maintains an ongoing collaborative relationship with providers, based on mutual respect, high quality outcomes and patient satisfaction. The credentialing specialist is responsible for provider enrollment and credentialing with all payers. Primarily, the credentialing specialist will be responsible for each application from initiation to approval and ongoing maintenance of provider enrollment and credentialing.

 

Responsibilities:

  • Develops ongoing, professional, and effective touchpoints with all active providers
  • Provides high level of customer service
  • Ensures accurate ongoing collection of key provider data element updates and changes
  • Performs updates to the provider database on a regular basis to ensure compliancy
  • Responsible for provider contract administration to ensure that all contract providers have a current and valid contract on file with all participating health plans
  • Supports providers through the credentialing/re-credentialing process, including addressing provider questions, and ensuring timely completion of applications
  • Responsible to develop relationships with all Health Plans
  • Coordinates and ensures all necessary logistics obtained to support a successful implementation (contracts, EMR access, onsite access, etc.)
  • Ensures provider compliance with all state and federal programs 
  • Proactive identification and resolution of plan gaps within a practice
  • Other credentialing, support and compliance duties as assigned

Minimum Qualifications/Requirements

  • 2 - 3 years administrative experience in the healthcare field preferred
  • Minimum High School diploma or GED
  • Highly organized with attention to detail
  • Ability to effectively prioritize multiple tasks and deadlines, with flexibility and capacity to identify and administer competing operational priorities in a changing environment with creativity and resourcefulness
  • Excellent verbal, interpersonal, judgment and problem-solving abilities
  • Ability to undertake assignments with minimum supervision and direction

Keplr Vision offers a competitive salary and benefits, 401K and a generous PTO plan.
BE A PART OF THIS AMAZING GROWTH AND JOIN OUR TEAM TODAY!
 


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Other details

  • Pay Type Hourly
  • Bloomington, IL, USA