Credentialing Specialist

Description

About the role

The Credentialing Specialist is responsible for all aspects of the MyEyeDr. Provider credentialing process, including gathering, verifying, reviewing, and maintaining all required credentialing documentation.

This position reports to the Manager, Credential Relations and is a hybrid/remote role, offering a flexible work arrangement out of our Vienna, VA or Raleigh, NC offices.

You Will

• On-board all New Hire & Acquisition doctors
• Set-up & maintain all credentialing requirements & documentation in the credentialing database
• Provide weekly tracking reporting on credentialing status
• Manage all doctor CAQH applications and ensure completeness with required information.
• Provide weekly tracking reporting on credentialing status
• Manage all doctor CAQH applications and ensure completeness with required information.
• Manage Annual Provider License, DEA & Control Substance documentation & Renewal process
• Coordinate Provider Dues and CE reimbursement, if appropriate
• Maintain various credentialing reports
• Maintain accurate provider profiles on CAQH and MyEyeDr. Credentialing database.
• Monitor Provider Tracking reports
• Credentialing liaison with Professional Services, Acquisitions, and Human Resources
• Delegated File Review Process
  o Perform & capture Primary Source Verifications on required sources
  o Identify discrepancies in information & conduct follow-ups
  o Maintain Provider Credentialing Files in accordance with NCQA standards and guidelines.
  o Perform Audits on credentialing files
  o Ensure compliance with applicable laws, regulations and policies and procedures
  o Credentialing Liaison Back-up Credentialing Committee when manager is unable to attend
  o Help maintain turnaround times on delegation agreement requirements
  

About You

• 2+ years’ of Credentialing experience preferred

• Bachelor’s degree in healthcare administration or a related field or the equivalent combination of education, training and experience.

• Role with highly visible verbal & written communication preferred
• Experience in Health Care field preferred
• Medicare and Medicaid credentialing knowledge preferred
• Outstanding verbal and written communication skills
• Strong history of customer service and relationship building
• Proven ability to collaborate and balance demands from multiple stakeholders
• High attention to detail and accuracy
• Strong problem-solving ability
• Strong follow-through and execution orientation
• Proven experience developing processes and efficiencies
• Intermediate to advanced Excel skills, strongly preferred

Grow with Us
Career Development and Training Opportunities
Participate in a comprehensive benefits package including medical and dental coverage, tax-free savings plans, life insurance and more
Participate in our Vision coverage and associate discounts on our products
Participate in our 401(k) with competitive company match
Accrue PTO and paid holidays from day one

Introduction | MyEyeDr.

How do you see yourself today? Are you looking for that unique opportunity where you can make a difference in the lives of the patients we serve? MyEyeDr. is a high-growth, premier healthcare company: a total vision care concept with a unique retail experience. Our trusted community doctors and knowledgeable teams are all focused on helping our patients live their best lives by delivering an exceptional, personalized experience to each of our patients in every interaction. Our business model is unlike others in the industry: we make healthcare accessible by welcoming all insurance and providing a great selection of stylish eyewear that meets the diverse needs of our patients.

This role provides a chance for you to build your professional career with an organization that is purposeful and whose values drive actions. You would have the opportunity to prioritize the care of our associates and our patients, to connect the knowledge of our talented teams to our patients’ needs, and to work in a fun, inclusive environment as part of a collaborative team. We are in search of that unique individual who is inspired by a career focused on helping others and providing quality care while continuously growing professionally and improving MyEyeDr. in meaningful ways. If this is you, we encourage you to apply so you can get your journey started with MyEyeDr. where you can help people see, look, and be their very best.