Insurance Credentialing Specialist, PT

Administrative/Clerical Lawrence, Kansas


Description

Take Your Career to the Next Level with LMH Health!

At LMH Health, we are committed to being a partner for lifelong health for the communities we serve. We are looking for a detail-oriented and patient-focused Insurance Credentialing Specialist to join our team! The Insurance Credentialing Specialist supports the LMH Health Revenue Cycle by independently managing and maintaining Physician and Allied Health Professional credentials through all insurance companies.  This position ensures timely and appropriate receipt and submission of documentation to garner payment for healthcare services rendered.

Top Reasons to work at LMH Health

  • Join a Team That Cares About the Community
  • Professional Development and Recognition
  • Tuition Reimbursement to Foster Professional Growth
  • Join a Team that Embraces a One Team One Goal Approach to Patient Care

RESPONSIBILITIES:

  • Coordinates and manages credentialing information for all LMH Health Physicians, Advanced Practice Practitioners, and Allied Health Professionals.
  • Ensures accuracy of provider demographic and credentialing data, submits credentialing applications for approval, including for those who practice in multiple sites, and communicates with stakeholders once approval has been received.
  • Maintains confidential credential files, including supporting documentation, in the electronic medical staff database.
  • Complete submission to national credentialing database, CAQH, upon provider on-boarding and every 60 days thereafter. 
  • Ensures all re-credentialing occurs prior to the given deadlines to avoid non-payment for services.
  • Builds and maintains a positive working relationship with payers, Risk Management, Medical Staff Office, and LMH Leadership.
  • Queries demographic and statistical information and distributes data as requested.
  • Proficient with computer and willingness to learn necessary computer software.
  • Assists with various organizational activities, including preparation of reports as directed.
  • Provides regular updates to HIMS Director regarding credentialing matters and requests assistance when needed.
  • Strong organization and communication skills and a commitment to quality and excellence in service are important components of the role.
  • Excellent customer service and interpersonal skills; must be tactful in dealing with people; discretion, good judgment, organizational skills, initiative, and the ability to work independently are especially important.
  • Performs other duties as needed or assigned.

 

QUALIFICATIONS:

Required:

  • Associate degree in a healthcare or business field of study.

Preferred

  • Bachelor’s degree in a healthcare or business field of study.
  • Two years credentialing experience.
  • Provider Credential Specialist (CPCS) certification, or in progress.

 

Our Values

Patient 1st – We consider the patient first in everything we do.

Better Together – We are part of the LMH team that works together to achieve excellence.

Speak Up – We embrace a transparent culture of open, respectful communication where ideas are valued and solutions are created.

Innovate! – We actively explore new ideas and approach change with agility and an open mind.

Own It/Solve It – We hold ourselves accountable for our actions and we collaborate for solutions.

In Joy – We create a workplace that is both fun and meaningful.

At LMH Health we value inclusion and diversity. We are an equal opportunity employer and encourage all to apply. Employment is decided on the basis of experience and qualifications that meet the business need.