Medical Staff Credentialing Specialist, Sr. jobs in Utah

Credentialing Specialist

Oracle BCC is currently seeking a proficient, and detail-oriented Credentialing Specialist. Oracle BCC provides healthcare administration services for individual providers and organizations. This is a full-time work-from-home position with flexible hours working Monday-Friday (at least ½ time during regular business hours).

The Credentialing Specialist is an important part of the Oracle team. Responsibilities include speaking on the phone to providers, insurance companies, and Medicaid and Medicare; collecting information and documents from providers and organizations; verifying education, licenses, and certifications; preparing and submitting requests for network participation and provider enrollment applications.

Oracle BCC operates within the Aegis family of companies across the healthcare industry operating in 3 states. Additionally, Oracle BCC contracts services to companies across the United States and is continuing to grow. There is an abundance of opportunities for professional development and growth.

Positive Work Environment

We encourage our employees to maintain work life balance and create a healthy work environment for the benefit of both employees and patients. We believe success comes when you surround yourself with passionate, dedicated, happy, and talented people.

Employee Incentives

Health Benefits

• Comprehensive Medical Plan
• Dental Plan
• Vision Plan
• Wellness Program

Financial Benefits

• 401(k) Retirement Savings Plan
• Life, Accident, & Disability Insurance

Personal Benefits

• Paid Sick Leave
• Paid Holidays
• Aegis Experience Rewards Program

Being the Difference

We are looking for employees with the following qualities:

• Thrive on establishing high level standards
• Committed to professionalism while performing job duties and responsibilities
• Positive attitude
• Team player
• Proactive problem solver
• Honesty and integrity

If you would like to be a part of an outstanding team that supports world-class providers, we look forward to hearing from you.

Credentialing Specialist Job Responsibilities:

• Comply with all CMS, Federal, and State requirements
• Maintain confidential records and data
• Monitor expiring licenses, certifications, and/or contracts with health plans
• Monitor the status of sent applications and follow up as needed
• Contact payers (insurance companies, Medicaid, Medicare) regarding network openings
• Review provider records for completion and accuracy
• Verify and document provider education, licenses, and certifications
• Maintain and track provider files and submitted participation requests
• Answer and receive phone calls and email promptly and courteously
• Respond to requests in an accurate and timely manner
• Establish and maintain effective internal and external working relationships

Skills & Qualifications:

• Computer proficiency - Microsoft Office Suite, Outlook, Teams, Chrome
• Minimum of 2 years experience in insurance credentialing as a Credentialing Specialist
• Keen attention to detail
• Database management experience preferred
• Adaptive problem-solving skills
• Must be comfortable making outbound calls to outside organizations
• Must not be excluded from state or federal program participation
• Criminal background check clearance/fingerprint clearance
• Must be at least (18) years of age

Ability to pass a criminal background check.