***Remote Opportunity***

Full-time: Benefit Eligible

Days: Monday - Friday

Hours: 8:00 AM - 4:30 PM

Essential Key Responsibilities:

• Initial credentialing and re-credentialing of physicians.
• Obtains Medical Licenses as required, as well as ensures that all Aurora Medical staff meet and maintain active licensure.
• Oversee the maintenance of all certifications required to successfully license and credential all physicians with the exception of the laboratory's CLIA licenses.
• Coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
• Conducts thorough background investigation, 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 Entity Credentialing Committees, ensuring file completion within time periods specified.
• Responsible for CAQH files for providers to ensure completion and maintain revisions/updates.
• Processes requests for Provider Enrollment ensuring compliance with criteria outlined in descriptions for both commercial and Government payers.

Education:

• Bachelor's Degree or the equivalent years of experience.

Experience:

• Four years related experience; or equivalent combination of education and experience.
• Ability to solve complex problems to support the planning, organizing, and coordinating of provider payer credentialing.
• Knowledge of medical terminology, insurance billing, credentialing and licensing processes as demonstrated by work experience and education.
• Must be able to effectively respond to questions from managers, employees, and outside entities.
• Evidence of the practice of a high level of confidentiality

• Ability to analyze complex reports and spreadsheets.
• Ability to organize priorities and projects.
• Ability to work proactively with little supervision.
• Ability to understand and work in a complex, multi-practice setting.
• Ability to demonstrate proficiency in data entry and keyboarding skills, Microsoft Word and Excel

Company:

Sonic Anatomic Pathology