Credentialing Specialist Details

Credentialing Specialist

NeoGenomics Laboratories - Aliso Viejo, CA

Employment Type : Full-Time

Are you motivated to participate in a dynamic, multi-tasking environment? Do you want to join a company that invests in its employees? Are you seeking a position where you can use your skills while continuing to be challenged and learn? Then we encourage you to dive deeper into this opportunity.

We believe in career development and empowering our employees. Not only do we provide career coaches internally, but we offer many training opportunities to expand your knowledge base! We have highly competitive benefits with HMO and PPO options. We have company 401k match along with an Employee Stock Purchase Program. We have tuition reimbursement, leadership development, and even start employees off with 16 days of paid time off plus holidays. We offer wellness courses and have engaged employee resource groups. Come join the Neo team and be part of our outstanding World Class Culture!

NeoGenomics is looking for a Credentialing Specialist within the Finance department in our Aliso Viejo, CA or Fort Myers, FL locations who wants to continue to learn in order to allow our company to grow.

Now that you know what we're looking for in talent, let us tell you why you'd want to work at NeoGenomics:

As an employer, we promise to provide you with a purpose driven mission in which you have the opportunity to save lives by improving patient care through the exceptional work you perform. Together, we will become the world's leading cancer reference laboratory.

Position Summary:

The Credentialing Specialist serves as a subject matter guide and assists with the application process to get to participating status with Medicare, Medicaid and Credentialing applications required for Managed Care Contracts. The Credentialing Specialist will research on the appropriate applications as required by each state for Medicaid Provider Enrollment. Interpret Medicare, Medicaid, Payer rules and regulations, documents relating to enrollment.

Core Responsibilities

• Complete required applications and forms timely and accurately.
• Submit the applications with all the required documentation.
• Follow up with applicable Agency, payer and status till on- par status is obtained.
• Track and report progress on a regular basis.
• Communicate regularly to Billing and Managed care
• Resolve any issues to enrollment non-payments
• Serve as a subject matter guide and assist with the application process to get to participating status with Medicare, Medicaid and Credentialing applications required for Managed Care Contracts.
• Research on the appropriate applications as required by each state for Medicaid Provider Enrollment.
• Interpret Medicare, Medicaid, Payer rules and regulations, documents relating to enrollment

Requirements

• Education: Bachelor's degree in a healthcare-related field or Finance from an accredited college or university is strongly preferred.
• 1+ year(s) demonstrated competency in knowledge, interpretation and application of documentation and basic understanding of billing rules
• Computer and Internet literacy;specifically with MS office applications and knowledge of Word, Excel is required.
• Experience with other programs is a plus

All qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.