Credentialing specialist work from home jobs - 506 jobs
Maternity Care Authorization Specialist (Hybrid Potential)
Christian Healthcare Ministries 4.1
Remote job
This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity.
WHAT WE OFFER
Compensation based on experience.
Faith and purpose-based career opportunity!
Fully paid health benefits
Retirement and Life Insurance
12 paid holidays PLUS birthday
Lunch is provided DAILY.
Professional Development
Paid Training
ESSENTIAL JOB FUNCTIONS
Compile, verify, and organize information according to priorities to prepare data for entry
Check for duplicate records before processing
Accurately enter medical billing information into the company's software system
Research and correct documents submitted with incomplete or inaccurate details
Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills
Review data for accuracy and completeness
Uphold the values and culture of the organization
Follow company policies, procedures, and guidelines
Verify eligibility in accordance with established policies and definitions
Identify and escalate concerns to leadership as appropriate
Maintain daily productivity standards
Demonstrate eagerness and initiative to learn and take on a variety of tasks
Support the overall mission and culture of the organization
Perform other duties as assigned by management
SKILLS & COMPETENCIES
Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management.
Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care.
EXPERIENCE REQUIREMENTS
Required: High school diploma or passage of a high school equivalency exam
Medical background preferred but not required.
Capacity to maintain confidentiality.
Ability to recognize, research and maintain accuracy.
Excellent communication skills both written and verbal.
Able to operate a PC, including working with information systems/applications.
Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access)
Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.)
About Christian Healthcare Ministries
Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
$31k-35k yearly est. 3d ago
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Patient Scheduling Specialist
Medasource 4.2
Remote job
Medical Support Assistant
Duration: 1 year contract (strong possibility of extension!)
Onsite: Denver, CO
Full Time: M-F, Day Shift
Overview: We are seeking reliable and mission-driven Medical Support Assistants to support Veterans served by a large healthcare system. MSAs provide critical front-line administration support across outpatient clinics and virtual care services.
Responsibilities:
• Customer service, appointment scheduling, and records management
• Answer phones, greet Veteran patients, schedule appointments and consults
• Help determine a clinic's daily needs, and verify and update insurance information
Required Qualifications:
• Minimum 6+ months of customer service experience
• 1+ year of clerical, call center, or healthcare administrative experience
• High school diploma or GED required
• Proficient with medical terminology
• Typing speed of 50 words per minute or more
• Ability to pass a federal background check
• Reliable internet for a remote work environment
$35k-42k yearly est. 23h ago
Cerner Oncology Scheduler
CSI Companies 4.6
Remote job
CSI Companies is seeking a Cerner Oncology Scheduler to work with one of our top healthcare clients!
Training: 2-weeks onsite training in South Bend, IN
Expenses: Travel expenses are reimbursed
Type: 100% Remote after training
Duration: 3+ Month Contract
Pay: $30 - $40/hour W2
Description:
Summary:
The Cerner Oncology Scheduler will provide staff augmentation support to maintain operational volumes across a high-volume outpatient oncology infusion center, medical oncology clinic, and gynecologic oncology center. This role is critical to ensuring continuity of care while the health system completes permanent hiring efforts.
Schedulers will work directly within Oracle Health Scheduling Appointment Book to manage complex oncology scheduling workflows, including patient intake, insurance verification, referral review, ICD 10 diagnosis review, treatment authorizations, orders, infusion appointments, provider visits, and coordinated multi-appointment care.
Key Responsibilities:
Interact directly with oncology patients.
Complete all operational patient intake tasks such as insurance verification, management of authorizations, referral management, and patient registrations.
Schedule outpatient oncology appointments using Oracle Health Scheduling Appointment Book, including:
Medical oncology clinic visits
Infusion appointments
Gynecologic oncology visits
Multi-visit and multi-resource appointment coordination
Accurately manage provider templates, infusion chair availability, and resource constraints
Coordinate care across clinics, infusion services, and ancillary departments
Apply oncology-specific scheduling rules, sequencing, and timing requirements
Communicate effectively with clinical teams, patients, and leadership regarding scheduling needs
Support operational throughput and access goals during staffing shortages
Adhere to organizational scheduling policies, workflows, and escalation paths
Required Qualifications
Minimum 2 years of hands-on experience scheduling oncology patients in Cerner
Demonstrated proficiency with Oracle Health CPM ambulatory specialist scheduling & Scheduling Appointment Book oncology infusion center scheduling.
Experience supporting outpatient oncology environments (medical oncology, infusion, and/or gynecologic oncology)
Strong understanding of the complexities and sequencing of oncology appointments
Ability to work independently with minimal ramp-up after onboarding
Willingness to travel onsite to Indiana for initial onboarding period
Preferred Qualifications
Experience in high-volume oncology infusion centers
Familiarity with oncology operational metrics (access, utilization, chair time optimization)
Prior contract or staff augmentation experience in healthcare settings
$30-40 hourly 4d ago
Scheduling Coordinator - Healthcare (Remote)
Access Telecare
Remote job
Who We Are:
Access TeleCare is the largest national provider of telemedicine technology and solutions to hospitals and health systems. The Access TeleCare technology platform, Telemed IQ, enables life-saving patient care through telemedicine and empowers healthcare organizations to build telemedicine programs in any clinical specialty. We provide healthcare teams with industry-leading solutions that drive improved clinical care, patient outcomes, and organizational health. We are proud to be the first provider of acute clinical telemedicine services to earn The Joint Commission's Gold Seal of Approval and has maintained that accreditation every year since inception.
We love what we do and if you want to know more about our vision, mission and values go to accesstelecare.com to check us out.
The Opportunity
We are seeking a detail-oriented and organized Scheduling Coordinator to join our Neurology Clinical Operations team. As a Scheduling Coordinator, you will support daily operational tasks related to our Neurology providers and assist with the management, development, and implementation of physician schedules in alignment with defined metrics and operational goals. Success in this position requires strong communication and organization skills, as you'll collaborate daily with clinicians, operations leaders, and internal teams to ensure schedule accuracy, efficiency, and seamless coordination across departments.
What You'll Work On
Collect, analyze, and interpret data from multiple sources to identify opportunities to optimize clinician schedules
Quickly get up to speed on Access Telecare's scheduling tool to support the analyses above
Generate & post Physician Schedules on a monthly basis utilizing predetermined availability to strategically maximize efficiency and meet/exceed target goal parameters.
Maintain real-time schedule changes.
Assist with the formation of facility specific physician panels as part of implementation process, depending upon existing & future State licensure/privileges.
Create summaries of coverage progress and remaining deficiencies
Compile capacity/coverage needs by service line, by physician group, or other criteria
Conduct outreach to clinicians to resolve capacity/coverage needs
Process shifts changes (extensions, change in start/end time, trades, etc.) in line with parameters set with service line leadership
Compile regular reporting on schedule performance
Enter monthly scheduling data into the scheduling software
Perform other duties and special projects as assigned
What You'll Bring
Bachelor's degree
Minimum of two years physician scheduling/workforce management or related experience preferred
Experience with quantitative analysis using tools like Microsoft Excel
Highly effective communication skills (written and oral)
Excellent organizational and project management skills, with an emphasis on hitting key deliverables/dates
Detail-oriented
Ability to collaborate across multiple cross-functional teams
Proficiency with Microsoft Office Suite and general computer skills
Company Perks
Remote Work
Health Insurance (Medical, Dental, Vision)
Health Savings Account
Flexible Spending (Medical and Dependent Care)
Employer Paid Life and AD&D (Supplemental available)
Flexible Vacation, Wellness Days, and Paid Holidays
About our recruitment process:
We don't expect a perfect fit for every requirement we've outlined. If you can see yourself contributing to the team, we would like to speak with you. You can expect up to 3 interviews via Zoom.
Access TeleCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, age, religion, color, marital status, national origin, gender, gender identity or expression, sexual orientation, disability, or veteran status.
$30k-39k yearly est. 1d ago
System Credential Verification Coordinator - PRN
Methodist Health System 4.7
Remote job
Education
Associates Degree preferred, minimum of High school Diploma or Equivalent required
Licenses and/or Certifications
Certification by the National Association of Medical Staff Services (CPCS or CPMSM) preferred
Related Work Experience and Other Skills
Work Experience: 2 years' experience with a minimum of one year in credentialing physician and allied health professionals
Knowledge/familiarity with MSO databases - preferred
Must have excellent oral and written communication skills
Must have excellent interpersonal skills and work effectively and efficiently with healthcare professionals both in and out of the hospital environment
Must be motivated as well as a self-starter who can work independently; however capable and willing to take direction as appropriate
Knowledge of medical terminology preferred
Computer skills to Operate Microsoft Outlook, Word, and Excel
Demonstrates loyalty, reliability, tactfulness, and honesty
Maintains emotional stability and a calm disposition
Exhibit a high degree of confidentiality
Must possess superb organizational skills
Remote opportunity but must be local to the Dallas/Fort Worth Metroplex to attend training and quarterly meetings
CVO Processes
Process Practitioner credentialing applications for Independent Practitioners and Allied Health Professionals in accordance with accreditation standards, regulatory requirements and policies and procedures;
Examine, research, and data enter information from practitioner application.
Gathers all information necessary to process information received from practitioners to support the credentialing process.
Determines applicant's initial eligibility for membership/participation
Obtains primary source verifications of education, training, experience, licensure, hospital affiliations, work history and peer references.
Obtains delineation of privileges and associated case logs/documentation.
Analyzes application and supporting documents for completeness and informs the practitioner of the application status, including the need for any additional information.
Maintains compliance with documentation standards for verification of credentialing requirements including but not limited to licenses, certifications, registrations, permits, education degrees, association membership and related electronic system and software
Responsible for the maintenance and accuracy of electronic credentialing files;
Verify and respond to telephone inquiries and written inquiries from practitioners and other departments, pertaining to practitioner and credentialing status in a professional and courteous manner.
Maintain all additions, terminations and charges to practitioners' membership and privileges.
Recognizes, investigates, and validates discrepancies and adverse information obtained from the application, primary source verifications, or other sources.
Act as a liaison between the medical staff and other departments of the hospital and provide assistance in the coordination of the duties of the medical staff related to credentialing and recredentialing.
Maintain the credentialing database assuring accuracy and completeness
Organize and maintain credentials files in the medical staff office
Maintain a working knowledge of the Medical Staff Bylaws Department rules and regulations; and Hospital Policies pertaining to medical staff, practitioner, and the organization to ensure the medical staff's adherence with stated parameters
Maintain compliance with regulatory and accrediting bodies; Joint Commission standards, State and Federal Law pertaining to the Medical Staff and apply them to the credentialing, privileging process as needed
Other Duties as Assigned - includes but is not limited to miscellaneous data entry after action by the Board of Directors, offering to help when certain applications become urgent.
Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America by
Modern Healthcare
, Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we've earned:
TIME magazine Best Companies for Future Leaders, 2025
Great Place to Work Certified™, 2025
Glassdoor Best Places to Work, 2025
PressGaney HX Pinnacle of Excellence Award, 2024
PressGaney HX Guardian of Excellence Award, 2024
PressGaney HX Health System of the Year, 2024
$44k-68k yearly est. Auto-Apply 60d+ ago
Licensing and Credentialing Specialist
Nema Health
Remote job
The Licensing and CredentialingSpecialist is a vital part of Nema's Clinical Operations team, responsible for the essential work of getting our providers ready to see patients. Reporting to the Senior Director of Clinical Operations, you will ensure our clinical team is licensed, credentialed, and enrolled with insurance payers in line with our clinic's growth plans. You are the bridge that connects a new clinician to a patient in need of life-changing trauma care.
In this role, you will manage the practical steps of a provider's journey at Nema, from navigating the different requirements of multi-state licensing to the details of insurance enrollment. You'll support clinician onboarding, and work closely with therapists and doctors to obtain and renew state licenses and relevant certifications.
You will work closely with the Operations, Clinical, and Revenue Cycle teams to resolve hurdles and make sure there are no gaps in patient care. This role is a great fit for a detail-oriented, persistent problem-solver who understands that behind every intricate step to the process is a clinician ready to help a survivor start their path to healing.
Responsibilities:
State Licensing
Complete initial and renewal applications for clinical state licensure for medical doctors, psychologists and therapists. Conduct follow-up and problem resolution as needed.
Work closely with individual clinicians to ensure collection and maintenance of licensing materials.
Track license and certification expirations for all providers to ensure timely renewals.
Keep management informed of progress and escalate issues as needed related to licenses and other relevant certifications.
Completes renewal process for controlled substance registrations and other relevant certifications
Organize CE requirements for medical and behavioral health staff, including management of vendor platforms that organize and support CE completion.
Credentialing & Payer Enrollment
Complete provider credentialing and re-credentialing licensing applications within state guidelines
Maintain accuracy of provider data in CAQH and internal databases
Ensure strict confidentiality of credentialing licensing files and databases
Enroll providers into new and existing health plans
Uphold all payer-specific policies and procedures
Daily Operations
Provide project assistance to clinical, operations and product departments as needed
Build and maintain reference materials and standard operating procedures
Qualifications
Required
3+ years of experience in state licensing applications (submissions, verifications, renewals) for medical and behavioral health providers
Experience with CAQH management and primary source verification
Experience managing insurance credentialing processes
A strength in organization and ability to prioritize multiple, sometimes conflicting, tasks
A sharp eye for detail and a level of persistence that matches the needs of this role
An ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization
Preferred
Early stage healthcare start-up experience
High School degree or higher
Nema Health is an early stage company looking to build and grow nationally. This is a full time, exempt, salaried position reporting to the Clinical Operations Sr. Director. Compensation will be determined by the candidate's experience and qualifications, with a base salary range of $60,000-$75.000. The full-time compensation package will include PTO, a healthcare stipend, a 401(k) with matching, an annual education stipend, an annual “work from home” stipend, and paid parental leave. This role is remote and the candidate can be located anywhere in the United States.
CredentialingSpecialist - REMOTE
Status: Full-time, Exempt
Schedule: Mon-Fri
Join us at Little Spurs! (Overview):
Little Spurs Pediatric Urgent Care and Little Spurs Autism Centers is looking to add a CredentialingSpecialist to our growing team! The CredentialingSpecialist will be responsible for maintaining the credentialing database, all licensures, insurance, board certifications for Little Spurs healthcare providers. The CredentialingSpecialist will work under the direction of the Central Business Office Manager to ensure effective operations and compliance with government/state regulations and UCA requirements.
What You Need (Qualifications):
High School diploma or equivalent
Minimum 3 years provider credentialing experience
Ability to meet and confer in a professional manner with Physicians and Physician extenders
Bachelor's degree in health care administration, business management, or related field (preferred)
Knowledge of credentialing software and ability to navigate payor portals
Provider enrollment/reenrollment (CAQH, PECOS, PEMS, TMHP, etc.)
Intermediate level of proficiency with Excel, Word, Outlook and Adobe
Delegated credentialing experience (preferred)
Knowledge of federal and state regulatory requirements and accreditation standards (i.e., Joint Commission, NCQA, UCA, and CMS) (preferred)
CPCS or CPMSM (preferred)
The Perks (Benefits):
Medical, Dental & Vision Benefits available employee, spouse, and dependents
Voluntary Short-Term & Long-Term Disability & Voluntary Life Insurance (Employee, Spouse, Children)
401k with 4% company match on 5% employee contribution
80 hours of PTO accumulated through the year; available for rollover
More PTO accrued after three and five years of service
No cost for in-house medical care for employee and dependent children
Employee recognition and appreciation programs
$31k-46k yearly est. 60d+ ago
Payer Credentialing Specialist
Our Billing Co LLC
Remote job
Job Description
Our Billing Co. is seeking a full time Payer CredentialingSpecialist to join our team!
The Payer CredentialingSpecialist is an important member of Our Billing Team. This individual is responsible for preparing the correspondence, gathering credentialing paperwork, and working with the credentialing vendor to file with the insurance. The Payer CredentialingSpecialist will coordinate with physicians, practice managers, practice directors, and executive-level leaders. Ultimately, the following functions serve to ensure no lapses of credentialing and to promote coordination with our vendor and Contracting teams to ensure coverage and participation with insurance for our patients and community.
Essential Functions:
Works with other department managers and staff-including physicians, managed care, contracting, and other professional staff-to acquire necessary materials and information for provider certification and licensure to promote organization-wide compliance with credentialing policies and procedures.
Provides oversight of verification and payer credentialing of health care professions and credentials are in compliance with state and federal standards.
Oversees process and organization of all-payer credentialing and re-credentialing paperwork with participating insurance companies.
Maintains a database of practitioner's training, education, licensing, and experience information.
Key liaison with Medical Staff team, outside vendor, and IT for HIS system updates.
Assists in filling out and reviewing applications with practitioners and other applicable staff Performs ongoing provider database maintenance for accuracy and completeness.
Performs ongoing provider database maintenance for accuracy and completeness.
Remains compliant with and knowledgeable of rules and regulations set forth by the Health Information Portability and Accountability Act (HIPAA), Joint Commission standards, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare & Medicaid Services (CMS), as well as state regulations-and relays this information to the necessary parties to ensure ongoing compliance organization-wide.
Minimum/Preferred Qualifications:
HS - High School Diploma or GED is required.
AA - Associates of Arts is preferred.
Minimum of two years of experience in physician credentialing is required.
Knowledge, Skills and Abilities:
Exemplary problem-solving and conflict-resolution skills.
Detail-oriented.
Skilled in synthesizing a wealth of information.
Exhibits excellent time management and prioritization abilities.
Communicates effectively both one-on-one and in a group setting.
Capable of following and providing detailed instructions both orally and through written communication.
Experience with credentialing database management software preferred.
Extensive experience working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Access, Project).
This job will be fully remote.
Our Billing Co. offers a competitive benefits package!
Pay Range: $24.00 - $30.00
Individual annual salaries/hourly rates will be set within job's compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and expertise of the individual and internal equity considerations.
$24-30 hourly 17d ago
Physician Credentialing Specialist
Salud Revenue Partners
Remote job
Salud Revenue Partners (Salud) is a technology-enabled service company with leadership and a high-performance culture that partners with healthcare providers nationwide to improve their revenue cycle performance.
Our vision is to be a national model for the delivery of revenue cycle services. We are at the forefront of innovation, applying next generation process automation and artificial intelligence to focus on the most productive work to help healthcare organizations resolve difficult accounts receivable, find gold in zero balance accounts, achieve the highest coding accuracy, and carry out patient-centered solutions to self-pay.
At Salud Revenue Partners, you can work for an organization dedicated to your employee development as well as delivering unparalleled results for our customers. We give staff objectives, exceptional training, and technology-enabled resources to accomplish goals and then set them free to get the job done. We encourage fresh ideas and a collaborative approach to delivering industry-leading solutions to clients.
What do our staff say about Salud? In May 2025 we were certified a Great Place to Work (for the 3rd year in a row), below are a few of our survey results:
97% of our employees say this is a great place to work!
97% of our staff say, "When you join the company, you are made to feel welcome."
97% of our employees say, "When I look at what we accomplish, I feel a sense of pride."
99% of our employees say, "People are encouraged to balance their work life and their personal life."
We are seeking an experienced Physician CredentialingSpecialist to manage the end-to-end credentialing and recredentialing process for medical providers with commercial, government, and managed care payers. This role ensures timely enrollment, compliance with regulatory standards, and accurate provider data maintenance to support uninterrupted patient care and reimbursement.
Key Responsibilities
Manage initial credentialing and recredentialing of physicians and mid-level providers (NPs, PAs) with commercial payers, Medicare, Medicaid, and managed care organizations
Complete and submit payer enrollment applications (CAQH, PECOS, state Medicaid portals, and payer-specific forms)
Maintain and update provider information in credentialing databases and internal systems
Monitor application status, follow up with payers, and resolve delays or discrepancies
Ensure compliance with payer requirements, NCQA, CMS, and state regulations
Coordinate with providers to obtain required documentation (licenses, DEA, malpractice, board certification, CVs)
Track credentialing timelines and proactively address expirations and reappointments
Collaborate with billing, contracting, and operations teams to ensure accurate provider enrollment
Prepare reports on credentialing status, turnaround times, and payer outcomes
Qualifications
High school diploma or equivalent required; associate's or bachelor's degree preferred
2+ years of physician credentialing and payer enrollment experience in a medical setting
Strong knowledge of Medicare, Medicaid, and commercial payer credentialing processes
Experience with CAQH, PECOS, and payer portals
Familiarity with NCQA, CMS, and state regulatory standards
Excellent organizational, time management, and follow-up skills
High attention to detail and ability to manage multiple deadlines
Strong written and verbal communication skills
Preferred Qualifications
Certified Provider CredentialingSpecialist (CPCS) or CPMSM certification
Experience working in multi-specialty or large medical group environments
Supervisory Responsibility
This position has no supervisor responsibilities.
Work Environment
This job operates in a professional cubicle or home office environment where standard office equipment such as computer, phones, photocopiers, filing cabinets and fax machines are utilized. The noise level in the work environment is usually minimal.
Physical Demands
While performing the duties of this job, the individual is regularly required to stand, bend, kneel, sit, walk, and use hands to touch, type, handle, or feel objects; reach with hands and arms; talk and hear. The vision requirements include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Individual may occasionally lift and/or move up to 10 pounds.
Position Type/Expected Hours of Work
This is a part-time remote position.
Travel
Travel when necessary for client work or training is expected for this position.
AAP/EEO Statement
Salud provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
$33k-49k yearly est. 21d ago
Medical Billing & Credentialing Specialist
Cuyahoga County Board of Health 3.8
Remote job
AVAILABLE
Medical Billing & CredentialingSpecialist Reports to: Director of Finance January 12, 2026 Position Type: Full-time, Bargaining
Starting Salary: $37,599 annually
Hours: Mon. - Fri., 8:30 a.m. to 4:30 p.m.
Vaccine Policy: All new hires will need to meet vaccination requirements or request an exemption and submit a TB Baseline as outlined in the CCBH Vaccination Policy.
Minimum Requirements:
Associate's degree in health information management technology or related field or two years of direct experience.
Minimum of three years of medical office and medical billing with collection experience. OR five years of experience (with HS Diploma/GED), OR one year of experience (with Bachelor's degree), OR no experience necessary (with Master's degree).
Certified Medical Coder and Certified Medical Insurance Specialistcredentials.
Ability to efficiently multi-task on a daily basis.
Strong knowledge of medical terminology, billing/collection processes, and insurance billing and coding (ICD-10 and CPT).
Knowledge of local, state, and federal billing regulations and third-party insurance program requirements.
Proficiency with use of databases for data querying and reporting.
Proficiency with use of PC hardware & basic software (i.e., Microsoft office), email, and office equipment (i.e., copier, fax, scanner, telephone, etc.).
Strong customer service, verbal and written communication skills, and organizational skills. Good interpersonal relationship skills including cultural sensitivity & competence.
Responsibilities:
Maintains up to date knowledge of third-party billing procedures and regulations in accordance with HIPAA, CMS, the ACA, etc. Leads the claims resolution process on behalf of the agency with third party providers. Provides assistance with the development, implementation and/or revision of policies/procedures governing CCBH's medical billing process.
Revises, corrects, and codes medical charges into the billing system. Enters/updates medical charges into billing system. Addresses and resolves billing discrepancies with third party providers.
· Verifies insurance eligibility and level of benefit coverage for clients.
Reviews all medical claims for accuracy prior to submission to the medical claims clearinghouse for payment processing. Collaborates with third party providers to resolve claims issues on agency's behalf.
· Assists with the updating and maintenance of the clinic fee schedule utilizing the CPT, HCPCS, and ICD-10 code databases.
Maintains up to date knowledge of the latest methods of data collection, coding, billing, collection, and claims submission. Serves as a resource to clinic staff related to the medical coding/billing process.
Receives and posts daily revenue from insurance carriers and direct client payments into the billing system and reviews and remedies any denials. Confers with the insurance carrier and/or clinic staff to resolve any discrepancies. Generates invoices to clients for balances owed.
Performs periodic reviews of CCBH contracts and agreements to ensure availability of the most current information for all medical insurance carriers, CCBH, and its providers. Consults with CCBH General Counsel for contract approvals and collaborate with the relevant clinic supervisory staff.
Completes/updates provider enrollment credentialing and credentialing process. Maintains timely and accurate entry of provider data in CAQH and all other required databases. Monitors expiring licensure, board and professional certifications, and other documents that expire for all providers and ensure timely renewals.
Collaborates with internal and external partners on special projects as assigned. Participates on internal and external subcommittees.
Develops and extracts reports from databases (i.e., EHR, etc.) for delivery to internal and external customers. Creates and runs regular reports for collections, billing, program statistics, etc. Gathers and organizes documents to satisfy client record audits or other reporting obligations.
Participates in public health emergency activities as needed.
May be required to operate agency-owned fleet vehicles at offsite service locations.
Performs other duties as assigned.
Please complete the online application on our website, *****************
All applicants are required to upload a resume and include a cover letter with their application.
Deadline to Apply: Posted Until Filled
Bilingual Applicants Welcome
Benefits offered at CCBH (for employees working at least 40 hours per pay period/Bi-weekly):
Medical (full time employees responsible for 10% of premium)
Dental (full time employees responsible for 10% of premium)
Vision
Public Employee Retirement System (PERS)
Deferred Compensation
FSA Health and Dependent Care
Tuition Reimbursement
Holidays (14 paid per year)
Vacation Time (13 paid days per year for new service PERS members*)
Sick Time (15 paid days per year*)
Personal Days (up to 3 paid per year)
Agency paid Life Insurance
Additional Voluntary Life Insurance
Voluntary Identity Theft Protection
Voluntary Critical Illness
Voluntary Accident Insurance
Employee Assistance Program
Free Parking Onsite
Remote work from home available up to two days per week with approval after the completion of a minimum of 60 days of employment.
Alternate work schedule or changes in work schedule available after initial training period with approval. Core work hours of 10am to 2pm required of all staff.
*Benefit is prorated based on start date
Employees hired for a position that is funded in whole or in part by a designated funding source may be laid off when the funding source is reduced or eliminated.
THIS AGENCY IS AN EQUAL PROVIDER OF SERVICES AND AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER CIVIL RIGHTS ACT 1964 THIS EMPLOYER PARTICIPATES IN E-VERIFY
All employees hired for a position must be legally authorized to work in the United States without requiring sponsorship for employment visa status now or in the future.
$37.6k yearly 40d ago
Credentialing Coordinator
Palm Medical Centers
Remote job
The Credentialing Coordinator is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process. Facilitates all aspects of credentialing, including initial appointment, reappointment, as well as clinical privileging for providers.
Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. Responsible for the accuracy and integrity of the credentialing database system and related applications.
Key Duties & Responsibilities:
Leads, coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
Research and primary source verification of all components of the application file.
Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
Prepares credentials file for completion and presentation to Health System Entity Medical Staff Committees, ensuring file completion within time periods specified.
Processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.
Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
Assists with managed care delegated credentialing audits; conducts internal file audits.
Utilizes the Cactus credentialing database, optimizing efficiency, and performs query, report and document generation; submits and retrieves National Practitioner Database reports in accordance with Health Care Quality Improvement Act.
Monitors the initial, reappointment and expired process for all medical staff, Allied Health Professional staff, Other Health Professional staff, and delegated providers, ensuring compliance with regulatory bodies (federal and state), as well as Medical Staff, Rules and Regulations, policies and procedures, and delegated contracts.
Performs miscellaneous job-related duties as assigned.
Required Skills/Abilities:
Excellent verbal and written communication skills.
Excellent customer service and phone skills.
Excellent organizational skills and attention to detail.
Excellent time management skills with a proven ability to meet deadlines.
Proficient with Microsoft Office Suite or related software.
Knowledge of related accreditation and certification requirements.
Knowledge of medical credentialing and privileging procedures and standards.
Ability to analyze, interpret and draw inferences from research findings, and prepare reports.
Working knowledge of clinical and/or hospital operations and procedures.
Informational research skills.
Ability to use independent judgment to manage and impart confidential information.
Database management skills including querying, reporting, and document generation.
Ability to make administrative/procedural decisions and judgments.
Supervisor Responsibilities:
None
Education and Experience:
High school diploma or GED; at least 3 years of experience with 1 year directly related to medical office staff or managed care credentialing. Certification/Licensure NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider CredentialsSpecialist (CPCS) or actively pursuing certification is preferred.
Physical Requirements:
Prolonged periods of sitting at a desk and working on a computer.
Must be able to lift up to 10 pounds at times.
This is a Remote position.
Palm is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm makes hiring decisions based solely on qualifications, merit, and business needs at the time.
$29k-44k yearly est. Auto-Apply 2d ago
Credentialing Specialist- 32 Hours
Saint Elizabeth Medical Center 3.8
Remote job
Job Type:
Regular
Scheduled Hours:
32 Reports to the Credentialing Manager, the CredentialingSpecialist verifies and maintains healthcare providers' qualifications (licenses, education, certifications, work history) to ensure compliance with regulations, payer requirements, and organizational standards, managing the end-to-end process from initial application to ongoing recredentialing for accurate documentation, timely onboarding, and proper reimbursement.
Job Description:
Job Title: CredentialingSpecialist
Hours: Full Time (32 Hours)
BENEFITS:
Work from home after training, equipment provided
Paid Time Off
Medical, Dental, and Vision
403b with Match
Opportunity for Career Growth- Career Ladder Program Tier I-Tier III
DUTIES AND RESPONSIBILITIES:
Comply with all applicable laws and regulations.
Accurate and timely completion of all new provider applications and re-credentialing applications.
Track and enter provider data into the system. Electronic files should be complete, current and accurate.
Maintain provider files of credentials, provider numbers and signed contracts. Paper files should be complete current and accurate.
Accurate and timely information is provided to contract carriers.
Maintain network and billing systems files for provider status.
Effective and timely communication with site and CBO for addressing credentialing issues.
Responsible for submitting Medical License and DEA invoices. Maintain an accurate and up to date log to ensure timeliness of renewals.
Answer telephones within 3 rings and is friendly and helpful.
Other duties as assigned.
EDUCATION:
Minimum: High School Diploma
YEARS OF EXPERIENCE:
Minimum 1-year experience in provider credentialing, revenue cycle or other related field
LICENSES AND CERTIFICATIONS:
N/A
REQUIRED SKILLS AND KNOWLEDGE:
Ability to manage and prioritize multiple tasks, knowledge of Excel, Word, Outlook and PowerPoint and the ability to learn other computer skills. Must have good organizational skills and work professionally with doctors, hospital administration and management, SEP employees and the public.
OTHER REQUIRED SKILLS AND KNOWLEDGE:
Understanding and knowledge of insurance credentialing application procedures.
Strong organizational skills.
Ability to maintain strict confidentiality, per corporate policies.
Knowledge of computer skills and applications.
Excellent communication skills.
Demonstrated ability to work successfully in a team-based decision-making culture.
Demonstrated ability to work independently resulting in effective outcomes and on-time performance.
Experience in planning and coordinating multi-disciplinary communications strategies, strategic initiatives, and events.
Must respond and follow through to requests from customers promptly.
Must work carefully and precisely with attention to detail.
Must utilize resources wisely.
Performs duties willingly and with initiative. Shares necessary information so co-workers can do the same.
Cooperates with other departments and work groups.
FLSA Status:
Non-Exempt
Right Career. Right Here. If you have a passion for taking care of the community and are interested in Healthcare, you will take pride in the level of care we provide at St. Elizabeth. We take care of patients and each other.
St. Elizabeth Physicians is an equal opportunity employer and will not discriminate on the basis of race, color, sex, religion, national origin, ancestry, disability, age or any other characteristic that is protected by state or federal law.
$29k-38k yearly est. Auto-Apply 16d ago
Enrollment & Credentialing Specialist
Healthsource of Ohio 3.7
Remote job
Centerprise Inc. is seeking to hire an Enrollment and CredentialingSpecialist to join our team. This is a hybrid-remote position that requires 30-days in office training. After 30 days, may be eligible to work a hybrid-remote schedule which will include 2-3 in office days per week.
Responsible for all aspects of the credentialing, re-credentialing, and provider enrollment processes for the providers of Centerprise's clients. Responsible for ensuring providers are credentialed and enrolled with health plans. Maintain up to date data for each provider in credentialing databases and online systems. Responsible for maintaining Centerprise's credentialing database. Communicates with Centerprise clients regarding credentialing and re-credentialing terms and changes. Assists operational and billing staff with health plan coverage issues.
About the Company:
Centerprise is a professional services organization providing consulting and Revenue Cycle Management services to Federally Qualified Health Centers (FQHCs). We are located outside Cincinnati, Ohio, and conduct business nationally.
Centerprise is a company on the rise! We are very excited to say that we currently employ 25 staff members, and we are steadily growing! We take great pride in focusing on employee satisfaction. Happy employees; means happy customers!
At Centerprise we offer our clients a wide variety of services, therefore, we require a large range of skill sets within our company. We would love to hear from dynamic individuals who are seeking an opportunity to grow their skills in an upbeat, fast paced, and team-based environment.
Centerprise has a small company feel, with larger company resources. Please refer to our website for more information, ***************
ESSENTIAL DUTIES AND RESPONSIBILITIES:
* Facilitate provider credentialing and re-credentialing, obtaining required information as needed. Coordinates procurement of DEA, licensure, malpractice insurance information, and other required information to process applications.
* Completes provider credentialing and re-credentialing applications; monitors applications and follows- up as needed. Ensures timely processing of all credentialing requests.
* Maintains knowledge of current health plan and agency requirements for credentialing and enrolling providers.
* Sets up and maintains provider information in online credentialing databases and systems, including CAQH and PECOS, to assure all credentialing information is accurate and up to date.
* Maintain and update credentialing reports. Keeps an updated log of all pending and completed work.
* Ensures practice addresses are current with health plans, agencies, and other entities.
* Audits health plan directories for current and accurate provider information.
* Communicates health plan coverage changes, additions, deletions across Centerprise and its clients.
* Acts as liaison with health plans and assists operations and billing staff on issues.
* Other duties as assigned
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty completely. The requirements listed below are representative of the knowledge skill and/or ability required.
Minimum Qualifications:
* To be eligible for remote portion, must have reliable Internet connection with a minimum download speed of at least 5Mbps, and upload speed at least 1 Mbps. Must have a dedicated work area with a door.
* High School Diploma or Equivalent (GED), Associate Degree preferred.
* Certified Provider CredentialingSpecialist (CPCS) preferred.
* Knowledge and understanding of the credentialing process. 2+ years of enrollment and credentialing experience required. FQHC experience is a plus.
* Ability to organize and prioritize work and manage multiple priorities.
* Excellent attention to detail.
* Ability to research and analyze data.
* Ability to work independently with minimal supervision.
* Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
* Proficiency with Microsoft Office Suite. Must be able to use Excel spreadsheets.
* Familiarity and experience with CAQH and NCQA
* Excellent written and oral communication skills
Benefits:
* Competitive benefits package, including options to enroll in the following programs: Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Flex Savings Accounts
* 401 (k) Program with competitive company match
* Courtesy Plan, full time staff and their immediate family members are eligible for courtesy treatment at any HealthSource of Ohio office up to $500.00 per family
* PTO and Long-Term Sick Bank, full time employees earn up to 25 days per year in first calendar year: 15 days of Paid Time Off (PTO), and 10 days of Long-Term Sick Bank (LTSB)
* Credit Union Privileges, Sharefax Credit Union
* Quarterly Bonus Incentive Program
Schedule:
* Monday to Friday; no evenings, or weekends
* 30-days in office training required. After 30 days, eligible to work a hybrid-remote schedule which will include 2-3 in office days per week.
Work Location: Hybrid remote in Loveland, OH 45140. Must be able to commute or planning to relocate before starting work.
Centerprise Inc. would love to hear from people who are seeking an opportunity to grow their skills in an upbeat, fast paced, and team-based environment.
Centerprise Inc. is an Equal Opportunity/Affirmative Action Employer:
Minority/Female/Disabled/Veteran
$33k-45k yearly est. 5d ago
Scheduling Specialist Remote after training
Radiology Partners 4.3
Remote job
RAYUS now offers DailyPay! Work today, get paid today!
RAYUS Radiology is looking for a Scheduling Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Scheduling Specialist, you will be responsible for providing services to patients and referring professionals by answering phones, managing faxes and scheduling appointments. This is a full-time position working 9:00AM - 5:30PM CST Mon-Fri, Rotating Saturday 7am-1pm CST.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
(85%) Scheduling Activities
Answers phones and handles calls in a professional and timely manner
Maintains positive interactions at all times with patients, referring offices and team members
Schedules patient examinations according to existing company policy
Ensures all appropriate personal, financial and insurance information is obtained and recorded accurately
Ensures all patient data is entered into information systems completely and accurately
Ensures patients are advised of financial responsibilities, appropriate clothing, preparation kits, transportation and/or eating prior to appointment
Communicates to technologists any scheduling changes in order to ensure highest level of patient satisfaction
Maintains an up-to-date and accurate database on all current and potential referring physicians
Handles overflow calls for other centers within market to ensure uninterrupted exam scheduling for referring offices
Provides back up coverage for front office team members as requested by supervisor (i.e., rest breaks, meal breaks, vacations and sick leave)
Fields 1-800 number calls and routes to appropriate department or associate (St. Louis Park only
(10%) Insurance Activities
Pre-certifies all exams with patient's insurance company as required
Verifies insurance for same day add-ons
Uses knowledge of insurance carriers (example Medicare) and procedures that require waivers to obtain authorization if needed prior to appointment
(5%) Other Tasks and Projects as Assigned
$33k-39k yearly est. 1d ago
Ministry Staff Coordinator, Africa - Link
Intervarsity USA 4.4
Remote job
Job Type:
Full time ATTENTION: Please do not apply here for this position without first reaching out to InterVarsity Link by writing ********************* to receive guidance on how to apply. InterVarsity Link exists to connect the US-based ministry of InterVarsity Christian Fellowship/USA with the global network of college fellowships in the IFES (International Fellowship of Evangelical Students).
In Africa alone, there are 80 countries where there is a Christ-focused presence on college campuses. The Ministry Staff Coordinator for Africa is a vital position that trains and equips Link Staff to serve in Africa. In addition, you listen and learn from local ministry leaders, deepening the partnership we have in the Gospel.Job Description
To advance the purpose of InterVarsity Christian Fellowship/USA, this position will:
Recruit, select, train, and provide member care for InterVarsity Link field staff - Student Ministry Leaders, Ministry Team Leaders, and Senior Ministry Specialists,
Develop a sense of Christian community and ministry partnership with leaders in the IFES region(s) to which they are assigned,
Facilitate specific ministry partnerships and exchanges between IFES regions or national movements with InterVarsity Christian Fellowship/USA
MAJOR RESPONSIBILITIES
Spiritual Growth:
Be a maturing disciple of Jesus Christ, growing in love for God, God's Word, God's people of every ethnicity and culture, and God's purposes in the world by:
Practicing daily spiritual disciplines
Pursuing spiritual relationships and involvement in a worshiping community
Continuing learning and growth in spiritual understanding, biblical knowledge, ministry experience and skills
Engage in spiritual leadership through teaching, preaching, discipling, leading Bible studies, and/or prayer and worship services in a local church or worshiping community
Experience and live out an ongoing call to ministry service with InterVarsity and its mission
Provide Member Care:
Provide spiritual and vocational support and direction to ministry staff by:
Providing for the pastoral care and spiritual development of Link staff in collaboration with IFES supervisors
Providing for the ministry training and professional development of Link staff in collaboration with IFES supervisors
Intervening in personal and team conflicts in collaboration with IFES supervisors as requested
Visiting the supervisory region annually, personally visiting new Link staff within their first year on the field
Oversee the MPD work of Link staff
Provide regular feedback and evaluation of the ministry and spiritual growth of Link staff
Administration:
Provide administrative services and financial management that enables Link staff to flourish in their ministry placements
Interface with InterVarsity departments to serve Link staff's needs
Ensure adherence to InterVarsity and InterVarsity Link policies, procedures, reporting requirements and financial guidelines
Partnering with the International Fellowship of Evangelical Students (IFES):
Build strong, trusting relationships with IFES leaders in the region to which the LSC is assigned
Work with IFES leaders to develop Seconding Agreements
Attend Regional and national conferences (at the request of IFES leaders) to lead in Bible study, worship, prayer, and ministry training
Be in contact with the IFES Regional Secretary regarding supervisory or pastoral care visits made to the region by the LSC or other representative of InterVarsity Link
Recruiting, Selecting, Placing, and Orienting:
Develop strong, trusting relationships with InterVarsity/USA staff directors and staff
Be available to InterVarsity regions to serve at staff and student meetings and conferences to lead in Bible study, worship, prayer, and ministry training
Participate in InterVarsity Link recruiting programs
Work with the Link Leadership Team (LLT) to review applications, interview applicants, make the final hiring decision, and, in collaboration with the IFES and the applicant, identify placement possibilities
Work with the Link Training Coordinator on the Link Orientation event and other orientation and debriefing resources for the new Link staff as needed
The Link Leadership Team (LLT):
Participate and be fully engaged as a member of the LLT and Link Staff Coordinator (LSC) Teams, to contribute to the accomplishment of the teams' plans
Actively engage in prayer for Link field staff personally and in team prayer meetings
Engage positively with the supervision you receive
Minstry Partner Development (MPD):
Raise 100% of salary and benefits
Communicate regularly and frequently with ministry partners
Adhere to InterVarsity/USA and InterVarsity Link MPD and Deficit Policy guidelines
Represent InterVarsity Link within InterVarsity/USA, with the IFES, and in the broader Christian community
QUALIFICATIONS
Annually affirm InterVarsity's Statement of Agreement (Doctrinal Basis and Purpose Statement). Abide by InterVarsity's Code of Conduct. Believe and behave consonantly with InterVarsity's Human Sexuality Theological Paper. Affirm and behave consonantly with InterVarsity's “Women in Ministry Statement of Affirmation”
Ongoing call to InterVarsity and the mission of the IFES
Bachelor's degree
2+ years living overseas or its equivalent
Ministry/missions experience including the ability to communicate spiritual vision, teach spiritual and biblical principles, plan ministry programs, and spiritually disciple, coach and mentor
Demonstrated cross-cultural skills
Demonstrated gifts in coaching, pastoral care, and training
Ability to supervise staff who are long distances away and living in high stress environments
Ability to organize ministry and training events
Ability to take charge of tasks and work independently without close supervision
Strong oral and written communication skills
Ability to work under the pressure of deadlines
Ability to maintain accurate records and files
Open to learn new concepts, methods and skills
A demonstrated ability and commitment to work collaboratively in a diverse, distributed team environment
A working knowledge of Microsoft software applications (Word, Access, Excel, and PowerPoint)
Pay Range: $53,328.00 - $71,112.00 per year
Pay: This position is funded through personal fundraising. Accordingly, compensation will vary based on the ability of the individual to secure a donor team to fund the cost of his/her salary. The anticipated salary range for this position on a full-time basis (40 hours/week) is dependent on a variety of factors, including location and cost of living. The actual salary received, including any geographic adjustment to account for location and cost of living, is subject to the individual's ability to raise funds necessary to cover the full amount of such salary within the range set forth in the job posting details.
Benefits:
We offer a competitive benefits package, including health care and retirement savings with a match. Eligibility is based on employee type and hours worked. Benefits include the following:
403(b) Retirement Savings Plan
403(b) matching contributions
Dental insurance
Employee assistance program
Employee discounts
Flexible work schedule
Flexible spending accounts
Health insurance
Health savings account
Life insurance
Paid time off
Parental leave
Professional development assistance
Vision insurance
Equal Employment Opportunity:
InterVarsity Christian Fellowship/USA is both an equal opportunity employer and a faith-based religious organization. We conduct hiring without regard to race, color, ancestry, national origin, citizenship, age, sex, marital status, parental status, membership in any labor organization, political ideology, or disability of an otherwise qualified individual. The status of InterVarsity Christian Fellowship/USA as an equal opportunity employer does not prevent the organization from hiring staff based on their religious beliefs so that all staff share the same religious commitment. Pursuant to the Civil Rights Act of 1964, Section 702 (42 U.S.C. 2000e 1(a)) InterVarsity Christian Fellowship/USA has the right to, and does, hire only candidates who agree with InterVarsity's Statement of Agreement: Purpose and Doctrinal Basis because InterVarsity believes that each and every staff plays a vital role in advancing InterVarsity's mission and purposes.
$53.3k-71.1k yearly Auto-Apply 60d+ ago
Central Scheduling Specialist- Remote
HMC External
Remote job
The Central Scheduling Specialist coordinates the verification, scheduling, pre-registration, and authorization for medical services. Responsibilities include the accurate collection and entry of required financial and demographic patient information, scheduling management to maximize the efficiency of the visit, communicating preparatory instructions, and collection of payment. This role requires a high level of independent judgment in order to successfully coordinate and obtain authorization requests for governmental and complex managed care patients in a timely and efficient manner. Utilizing telecommunications and computer information systems, this individual will be responsible for handling inbound and outbound calls with a focus on exceptional service to patients, employees, and providers. In order to ensure an extraordinary patient experience, multitasking between different patient care areas will be required. The Central Scheduling Specialist is best defined as a highly independent and flexible resource that functions in alignment with the patient experience initiative. Performs all job duties and responsibilities in a courteous manner according to the Hurley Family Standards of Behavior.Works under the supervision of the department director or designee who assigns and reviews conformance with established procedures and standards.
High school graduate and/or GED equivalent.
Associate's degree in Business Administration or equivalent degree.
-OR-
Two (2) years of experience working in a call center or experience performing scheduling, registration, billing or front-desk responsibilities in a medical (hospital or physician office/clinic) setting
Knowledge of a call center environment and capable of handling a high call volume while maintaining high performance.
Knowledge of registration, scheduling, authorization, and referral policies and procedures relative to an outpatient clinic and surgical setting.
Demonstrates extensive knowledge of insurance plan pre-certification/referral requirements and processes.
Working knowledge of medical terminology, procedure and diagnosis coding, and billing procedures.
Proficient in business office information systems & software such as Google Suite & Microsoft Office containing spreadsheet and database applications.
Manage multiple, changing priorities in an effective and organized manner, under stressful demand while maintaining exceptional service. Maintain composure when dealing with difficult situations and responding professionally.
Independently recognize a high priority situation, taking appropriate and immediate action. Make decisions in accordance with established policies and procedures.
Knowledge of hospital operations and / or Ambulatory Clinic operations.
Excellent verbal and written communications skills and a pleasant and professional phone demeanor.
Ability to develop effective relationships with colleagues, physicians, providers, leaders, and other across the organization.
Demonstrates a genuine interest in helping our patients, providers, and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure.
PREFERRED QUALIFICATIONS: Working knowledge of Epic Revenue Cycle applications: Resolute Hospital Billing, Resolute Professional Billing, Single Business Office, Cadence, or Grand Central.
Schedules, cancels, reschedules appointments / services for designated departments. Manages scheduling to maximize the efficiency of the visit / provider. Monitors appointment schedules daily for cancellations, rescheduling, and no shows as well as other stats or changes; communicates timely with all departments impacted. Generates daily-weekly-monthly reports in order to manage schedules and distributes information as needed.
Performs pre-registration functions within designated time frame in advance of the patient appointment (including, but not limited to) obtaining and / or verifying demographic, clinical, financial, insurance information, and eligibility for scheduled service / procedure. Confirms Primary Care Provider making necessary updates as appropriate.
Identifies insurance companies requiring prior authorization and / or referrals for services and obtains authorization / referral for all services. Coordinates incoming / outgoing authorizations for procedures and testing requested by providers for all government and third-party payers, including emergent authorizations due to walk-in patients.
Informs the patient of their visit-specific preparatory instructions and ensures notification about their upcoming appointments. Schedules pre-admission testing when needed and assists in arranging necessary lab orders. Obtains all necessary information required by third-party payors for treatment authorization requests.
Courteously accepts and places telephone calls, and interacts with physicians and associates while providing services. Resolves or tactfully directs complaints, problems; obtains information and responds to inquiries within 24-48 hours. Frequently communicates with patients/family members/guarantors, physicians/office staff, medical center, and payors via telephone, email, enterprise EMR or other electronic services. Escalates issues that cannot be resolved in accordance with departmental guidelines.
Performs price estimates upon patient request in order to assist the patient in identifying their expected full patient liability and / or residual financial responsibility.
Educates the patient relative to their insurance policy / benefits. Collects patient / guarantor liabilities and refers patients who are uninsured / underinsured to Insurance Services Specialists for financial assistance or governmental program screening and application processes. Refers patients to the Financial Customer Service Specialist to resolve outstanding self-pay balances.
Maintains a log / guide with up-to-date information related to services in need of pre-certification or require referrals per insurance carrier. This includes compliance with regulatory requirements and ensuring all changes are incorporated into daily job functions.
Works with the coding department to validate the accuracy of the authorized service in comparison to the procedure performed. Discrepancies are addressed immediately within timelines set forth by the specific payer's guidelines for correction. Reports procedural updates to leadership.
Triages misrouted telephone and patient portal inquiries promoting an exceptional patient and provider experience. Makes follow-up calls to provider offices and / or testing sites to ensure receipt of all necessary information for the patient's visit.
Recommends modifications to existing policies or workflows that support the values of Hurley Medical Center and will increase efficiency and promote data integrity.
Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully perform duties on a day-to-day basis. Able to work in a fast-paced call center environment while maintaining efficiency and accuracy.
Performs other related duties as required. Utilizes new improvements and/or technology that relate to job assignment. Involvement in special projects as needed.
$27k-41k yearly est. Auto-Apply 1d ago
Clinical Scheduling Specialist
Midi Health
Remote job
Master Clinical Scheduler @ Midi Health: 👩 ⚕️💻
Midi is seeking an experienced Master Scheduler to join our cutting edge healthcare start-up. This is a rare opportunity to start at the ground level of a fast-growing healthcare practice! We offer a flexible work schedule and 100% remote environment with a competitive salary, benefits and a kind, human-centered environment.
Business Impact 📈
Sole responsibility for creating every Midi clinician's schedule in Athena
Daily monitoring of clinician schedules
Management of patient waiting list to backfill patients as times become available
Rescheduling of patients as needed
Adjustment of clinician schedules as needed
Cross-coverage of Care Coordinator Team responsibilities as assigned
What you will need to succeed: 🌱
Availability! 5 days per week, 8 hour shift + 30 min unpaid lunch - 9:30 AM to 6 PM PST
Minimum of five (3) years as a Clinical Scheduler building clinician schedules (preferably in AthenaHealth)
Minimum of 1 year experience working for a digital healthcare company
Proficiency in scheduling across multiple time zones
Self-starter with strong attention to detail
What we offer:
Compensation: $30/hour, non-exempt
Full Time, 40-hour work-week
Fully remote, work from home opportunity!
Benefits (medical, dental, vision, 401k)
The interview process will include: 📚
Interview with Recruiter (30 min Zoom)
Interview with Scheduling Supervisor + Lead Scheduler (30 min Zoom)
Final Interview with Practice Manager (30 min Zoom)
***Scheduled Shift Time is M-F 9:30am-6pm PST***
Thanks for your interest in Midi 👋While you are waiting for us to review your resume, here is some fun content to check out! Check us out here and here. Trust that our patients love❣️us! #Menopauseishot
#LI-DS1
Please note that all official communication from Midi Health will come from **************** email address. We will never ask for payment of any kind during the application or hiring process. If you receive any suspicious communication claiming to be from Midi Health, please report it immediately by emailing us at ********************.
Midi Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Please find our CCPA Privacy Notice for California Candidates here.
$30 hourly Auto-Apply 13d ago
Booking & Scheduling Specialist
Traveling With McHaila
Remote job
We're seeking a reliable and detail-oriented Booking & Scheduling Planner to support clients by coordinating schedules, managing bookings, and ensuring a seamless experience from start to finish. This fully remote role is ideal for someone who enjoys organization, client communication, and keeping details running smoothly. This is perfect for individuals who can work independently while using the resources and tools provided.
What Youll Do:
Manage bookings, schedules, and confirmations
Communicate with clients to gather details and provide updates
Ensure accuracy and timely follow-ups
Deliver professional, friendly support throughout the process
What Were Looking For:
Strong organizational and communication skills
Customer service or administrative experience (preferred, not required)
Comfortable working independently in a remote setting
Detail-oriented, dependable, and tech-comfortable
Must be able to book, plan and create itineraries for clients and deliver quotes from start to finish
Must be a citizen of the US, UK, Australia, Mexico, Spain and LATAM
Why This Role Stands Out:
100% remote flexibility
Training and ongoing support provided
Opportunity for growth within a supportive team
$33k-48k yearly est. 6d ago
V104 - Intake and Scheduling Specialist
Flywheel Software 4.3
Remote job
For ambitious, culturally diverse, curious minds seeking booming careers, Job Duck unlocks and nurtures your potential. We connect you with rewarding, remote job opportunities with US-based employers who recognize and appreciate your skills, allowing you to not just survive but thrive.
As a lifestyle company, we ensure that everybody working here has a fantastic time, which is why we've earned the Great Place to Work Certification every year since 2022!
Job Description:
This role at Job Duck offers the opportunity to support a fast‑paced professional environment where responsiveness and smooth communication truly make a daily impact. The position centers around assisting clients with care, managing incoming calls with a warm and engaging presence, and ensuring that follow‑ups and intakes are handled with clarity and consistency. You will contribute by preparing polished templates, maintaining accurate spreadsheets, and coordinating schedules so operations run seamlessly.
A candidate who thrives in this role enjoys interacting with others, communicates with confidence, and stays organized even when navigating multiple software tools at once. If you bring strong English skills and a naturally outgoing approach to your work, you will excel here.
• Salary Range: 1,150 USD to 1,220 USD
Responsibilities include, but are not limited to:
Client intake and follow-up.
Templates drafting.
Create and maintain spreadsheets
Support general administrative functions
Handle scheduling and calendar coordination
Answering phone calls (approximately 10/day), it can vary
Requirements:
Strong written and spoken English
Excellent grammar and communication skills
Responsive and detail‑oriented
Comfortable using multiple software platforms simultaneously
Outgoing communication style
Ability to stay organized while handling varied administrative tasks
CRM: Lawmatics
VoIP: RingCentral
Internal communication: Microsoft Teams Channel, Slack
Outlook
Work Shift:
9:00 AM - 6:00 PM [EST][EDT] (United States of America)
Languages:
English, Spanish
Ready to dive in? Apply now and make sure to follow all the instructions!
Our application process involves multiple stages, and submitting your application is just the first step. Every candidate must successfully pass each stage to move forward in the process.
Please keep an eye on your email and WhatsApp for the next steps. A recruiter will be assigned to guide you through the application process. Be sure to check your spam folder as well.
$30k-43k yearly est. Auto-Apply 7d ago
Medical Central Scheduling Specialist - Remote
Qualderm Partners 3.9
Remote job
Job Description
Candidates must reside within a reasonable driving distance of Lombard, IL.
Hours Scheduled: Mon-Thurs 9:30am-6pm/Fridays 8am-5pm
QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S., with over 150 locations across 17 states. Our commitment is to educate, protect, and care for your skin while delivering the highest quality dermatological services. We strive to make skin health accessible to all while fostering a rewarding work environment for both our patients and employees.
Position Summary:
The Remote Central Scheduling Specialist will be responsible for managing and coordinating the scheduling of patient appointments across our various practice locations. This role requires exceptional customer service skills and the ability to handle a high volume of calls while ensuring that each patient feels valued and supported throughout their scheduling experience.
Requirements
High School Diploma required; Associate's Degree preferred.
Minimum of 1 year customer service experience in a healthcare setting preferred.
Strong communication and interpersonal skills.
Ability to manage multiple tasks efficiently in a fast-paced environment.
Proficiency in scheduling software and Microsoft Office applications.
Understanding of HIPAA regulations is a plus.
Benefits
Competitive Pay
Medical, dental, and vision
401(k) - The company match is 100% of the first 3%; and 50% of the next 2%; immediately vested
Paid Time Off - accrual starts upon hire, plus 6 Paid Holidays and 2 floating days
Company paid life insurance and additional coverage available
Short-term and long-term disability, accident and critical illness, and identity theft protection plans
Employee Assistance Program (EAP)
Employee Discounts
Employee Referral Bonus Program
QualDerm Partners, LLC is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Compensation Range: $17.00 - 19.50 per hour. Final offer will be based on a combination of skills, experience, location, and internal equity.