Credentialing Specialist

Dr. Tavel Optical Group is a well-established company with 24 locations throughout Indiana. We provide outstanding eye care services and offer a wide selection of fashionable eyewear. We are currently seeking a skilled and experienced Credentialing Specialist to join our team.

As a Credentialing Specialist, you will be responsible for managing the credentialing process for our healthcare providers. This includes verifying and documenting the credentials of our providers, ensuring compliance with regulatory requirements, and maintaining accurate records. You will work closely with our providers, insurance companies, and regulatory bodies to ensure that our providers are credentialed and able to provide high-quality care to our patients.

Pay Range: $18.00 - $24.00 per hour, commensurate on experience

Location: Hybrid or Remote within the State of Indiana

Responsibilities:

• Initiate, coordinate, and manage credentialing process for all new providers joining our practice
• Gather and verify all required documents, including licensure, certifications, education, malpractice insurance, and other relevant credentials
• Submit and follow up on credentialing applications efficiently to ensure timely approval and provider enrollment
• Ensure compliance with regulatory standards while maintaining confidentiality of sensitive information
• Manages all re-evaluations for Medicare and Medicaid
• Monitor credential expiration dates ensuring licenses remain current and up-to-date, sending reminders, and submitting recredentialing applications and any necessary updates to insurance companies and other relevant organizations
• Ensure providers maintain compliance with all credentialing requirements and standards
• Manages disability and legal medical requests and safety account
• Maintains database containing accurate and up-to-date licenses, certifications, board status, insurance credentialing status, etc.
• Track credentialing status, expiration dates, and renewal deadlines for providers
• Generate reports and updates regarding provider credentialing status for internal use and compliance purposes
• Serve as the primary point of contact for providers regarding credentialing inquiries and updates
• Communicate effectively with insurance companies, regulatory agencies, and other external stakeholders to facilitate the credentialing process
• Collaborate with internal departments, including HR, billing, and compliance, to ensure seamless coordination of credentialing activities
• Other duties as assigned

Requirements

• At least 2 years of previous credentialing experience required, 3-5 years of experience preferred
• Knowledge of insurance operating procedures, regulations, and billing requirements and government reimbursement programs
• Advanced organizational and prioritization skills with ability to manage multiple tasks
• Ability to work independently and be self-directed, but also a team player
• Strong attention to detail and communication skills
• Demonstrated proficiency in Excel - Intermediate level and a working knowledge of Outlook
• Experience working in Acuity Logic and EHR a plus but not required

Benefits

• Paid Time Off and Company Paid Holidays
• 401(k)
• Health, Rx, and Dental Insurance
• Paid Parental Leave
• Vision Perk -- Free eye exams and glasses for you + large discounts for family
• Company Paid Life Insurance