Job Summary

Credentialing/Provider Enrollment Coordinator handles all provider and facility credentialing and provider enrollment.

ESSENTIAL JOB FUNCTIONS (other duties as required):

• Must know Current Procedural Terminology (CPT) and ICD10
• Responsible for Provider, Facility and Location Credentialing and Enrollment and/or Disenrollment
• Responsible for updating provider, location and facility demographics with the various payers
• Responsible for Provider Licensing
• Insurance Contract Liaison
• Responsible for insurance contract analysis to include payer payment audits
• Maintain and Update Provider and Facility Credentialing Files
• Responsible for Maintaining and Updating CAQH and NPPES
• Accountable for exclusion screening function.
• Adherence to applicable laws, regulations and contractual obligations. Follows the principles of the Compliance Program as well as the Code of Conduct.
  
  
  

Reasonable accommodations may be made to individuals with disabilities to perform the essential functions.

COMPETENCIES:

• Demonstrated ability to follow oral and written instructions.
• Demonstrated knowledge of material, methods, instruments and equipment.
• Demonstrated ability to read, write and perform mathematical calculations.
• Must be able to maintain high degree of confidentiality. Ability to multi-task, work in a fast-paced environment and manage time accordingly in order to meet deadlines and requirements of the organization.
  
  
  

SUPERVISORY RESPONSIBILITIES:

The position has no supervisory responsibilities.

Work Environment

The work characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Fast-paced, deadline oriented, confidential department. The noise level in the work environment is usually moderate.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Demonstrated ability to do excessive walking, standing, bending and stooping. While performing the duties of this job, the employee is frequently required to stand, sit, use hands to handle or feel objects, tools or control, reach with hands and arms and talk or hear. The employee is occasionally required to climb or balance, kneel and crouch.

The employee may be required to lift moderately heavy objects (50-90 pounds). Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Position Type And Expected Hours Of Work

This is a full-time position. Days and hours are Monday through Friday 8:00 A.M. – 5:00 P.M. with occasional overtime.

Travel

Travel may be required. REQUIRED EDUCATION AND EXPERIENCE:

• A high school graduate
• Knowledge of CPT and ICD10
• Knowledge of NextGen
• Computer proficiency
• Leadership and management experience
  
  
  

PREFERRED EDUCATION AND EXPERIENCE:

• Bachelor’s Degree
  
  
  

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

Benefits

401(K) Company Match

Medical and Dental Insurance

Vision Benefits

Flexible Spending Accounts

Pet Insurance

Disability Insurance

Life Insurance

Continuing Education

Paid Time Off

US Eye provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.