Medical Staff Credentialing Director jobs in Cleveland, OH
Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Being a Medical Staff Credentialing Director maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Additionally, Medical Staff Credentialing Director analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
Recently Added Medical Staff Credentialing Director jobs
- Cleveland Kidney & Hypertension Consultants
-
Cleveland, OH
FULL_TIME
-
Employment with CKHC
Open Positions
Join our warm and friendly staff in our independently owned practice, with top doctors, a wonderful work environment, and competitive salary and benefits.
Send a cover letter and your resume to clevelandkidney@gmail.com
Medical Billing & Credentialing Specialist
Only experienced Billers need apply. This is not an entry-level or trainee position.
Cleveland Kidney & Hypertension Consultants is a small medical practice known for taking excellent care of our patients and having a great staff!
We have an immediate opening for an experienced full-time Billing and Credentialing Specialist. This position is responsible for submitting charges to insurance companies, processing Medicare, Medicaid, and private insurance payments and takebacks, denials and rejections; verification and collection of unpaid claims; and account follow-up.. The successful candidates will have at least 3 years of healthcare billing in a busy office and have worked with insurance web portals and Availity. Experience with credentialing is a plus but we are willing to train on the job if you have tech savvy.
Some of the duties include, but are not limited to:
Run claims tracking reports and follow up
Review rejected and denied claims and do what’s necessary to get them paid
Verification of all benefits eligibility including Medicare and Private Insurance
Provide Additional Documentation Requests
Know the rules for adding modifiers and the order of CPT codes
Prepare Denials and Rejection reports weekly for Supervisor
Submit charges and work rejections
Credentialing providers with insurance companies and hospitals
Enter office and weekend call schedule on the company calendar
Process payments from insurance companies and review low payments
Required Skills:
Experience in medical billing and claims processing
Attention to details.
Fast keyboarding skills
Very meticulous about documenting your work on the computer, not on paper
Accuracy with data entry.
Computer skills (email, Word Excel spreadsheets, etc.).
Enthusiastic.
Good at multitasking, and teamwork
Ability to start working immediately.
Reliable
College degree or some college with experience is a plus.
CDCA not required
Nice to have experience: RSL, EPIC, Availity, Google Calendar, gmail
Only experienced Billers need apply. These are not entry-level or trainee positions. We offer excellent pay with benefits and a updated professional work environment.
We believe your success is our success, so you will have our full support!
Email resume today to Jan at ckhcjd@gmail.com
Job Type: Full-time
Benefits:
401(k)
Health insurance
General Schedule, with some flexibility::
Monday - Thursday. 8-4, Fridays 8-12,
Work Location: Private Office in Euclid, Ohio near Richmond Rd/260th Street and Euclid Ave.
Work is in our nice office.
You must have a reliable car with a commute of less than 40 mintues.
CKHC is located on Cleveland’s beautiful east side. We enjoy the best a strong Midwest city has to offer including excellent daycare and school options for kids and lively night life for adults. For adults and children, culture is key here, with top notch museums, theater, music and a resurging downtown with restaurants, galleries, shopping, bars, and more. Lake Erie with its water sports and fishing is also a big draw! Blossom Music Center is the summer home of the world-famous Cleveland Orchestra and attracts major national and international entertainment. You can root for the Cleveland Browns, the Cleveland Guardians or the Cavaliers!
In a little more than an hour’s flight, or a pleasant few-hours drive, you can visit New York, Chicago, Washington DC, Niagra Falls or Toronto.Only experienced Billers need apply. This is not an entry-level or trainee position.
Cleveland Kidney & Hypertension Consultants is a small medical practice known for taking excellent care of our patients and having a great staff!
We have an immediate opening for an experienced full-time Billing and Credentialing Specialist. This position is responsible for submitting charges to insurance companies, processing Medicare, Medicaid, and private insurance payments and takebacks, denials and rejections; verification and collection of unpaid claims; and account follow-up.. The successful candidates will have at least 3 years of healthcare billing in a busy office and have worked with insurance web portals and Availity. Experience with credentialing is a plus but we are willing to train on the job if you have tech savvy.
Some of the duties include, but are not limited to:
Run claims tracking reports and follow up
Review rejected and denied claims and do what’s necessary to get them paid
Verification of all benefits eligibility including Medicare and Private Insurance
Provide Additional Documentation Requests
Know the rules for adding modifiers and the order of CPT codes
Prepare Denials and Rejection reports weekly for Supervisor
Submit charges and work rejections
Credentialing providers with insurance companies and hospitals
Enter office and weekend call schedule on the company calendar
Process payments from insurance companies and review low payments
Required Skills:
Experience in medical billing and claims processing
Attention to details.
Fast keyboarding skills
Very meticulous about documenting your work on the computer, not on paper
Accuracy with data entry.
Computer skills (email, Word Excel spreadsheets, etc.).
Enthusiastic.
Good at multitasking, and teamwork
Ability to start working immediately.
Reliable
College degree or some college with experience is a plus.
CDCA not required
Nice to have experience: RSL, EPIC, Availity, Google Calendar, gmail
Only experienced Billers need apply. These are not entry-level or trainee positions. We offer excellent pay with benefits and a updated professional work environment.
We believe your success is our success, so you will have our full support!
Email resume today to Jan at ckhcjd@gmail.com
Job Type: Full-time
Benefits:
401(k)
Health insurance
General Schedule, with some flexibility::
Monday - Thursday. 8-4, Fridays 8-12,
Work Location: Private Office in Euclid, Ohio near Richmond Rd/260th Street and Euclid Ave.
Work is in our nice office.
You must have a reliable car with a commute of less than 40 mintues.
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