Credentialing specialist Jobs in Washington, DC

Description

Purpose & Scope :

Oversees payer credentialing and contracting process for new providers joining Virginia Hospital Center’s employed multi-specialty physician group. Directly manages Credentialing Specialist. Serves as primary point of contact related to credentialing and contracting with managed care plan representatives, billing team, physician group management. Completes complex financial reports and analyses for revenue cycle management and managed care contracting.

Education :

Bachelor's degree in healthcare administration is required.

Master's degree in a related field is preferred.

Experience :

Three years of experience in credentialing and quantitative analysis experience is required.

Two years of experience in managed care contracting and physician billing is required.

Demonstrated leadership ability is required.

Certification / Licensure :

None.

Physical Requirements :

Administrative : The work environment characteristics described here are representative of those an employee may encounter while performing the essential function of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essentials functions : Repetitive movement of hands and fingers - typing and / or writing. Walking : moving about on foot to accomplish tasks, sometimes for long distances. Frequent standing, walking, stooping, kneeling or crouching. Reach with hands and arms. Frequent communications, verbal and written, and auditory acuity. Visually or otherwise identify, observe and assess. Cope with mental, emotional stress associated with this position. Operate Office machines properly and in accordance with Hospital safety standards. Perform light lifting (up to 15 pounds). Ability to work within deadlines with frequent interruptions. Ability to work in accordance with Hospital Safety Standards.

Working Conditions :

Administrative : Works in a well-lighted / ventilated office setting. Subject to frequent interruptions. Willing to work beyond normal working hours when requested to do so. Minimal occupational exposure to infectious diseases, blood borne pathogens, hazardous chemicals, noxious odors, latex, or musculoskeletal injuries. May encounter patients, family members, co-workers, and visitors under all conditions, e.g. hostile and / or emotionally upset.