Description:
Oticon Medical is a Hearing Implant company providing solutions for those with hearing losses that a hearing aid cannot treat. The Credentialing Specialist is a member of the Insurance Team and responsible for improving access to our life changing technologies. To accomplish this, we're looking for an individual who shares our sense of excellence, is ready to embrace change, never settle for the status quo, who has the confidence to develop a new arm to our services, and who never wants to stop learning/improving.
Responsibilities
- Obtain pertinent data from providers to initiate the credentialing process
- Perform quality review audits of credentialing files
- Maintain up to date data for sales territory
- Track Oticon Medical’s licenses, certifications, and professional liability insurances to ensure timely renewals
- Maintains standards set forth by internal policies and procedures and local and federal regulatory requirements
- Coordinates with the insurance and field teams to stay ahead of pertinent insurances
- Interact with internal departments and varied levels of management, to accomplish credentialing timelines
- Meet or exceed departmental timeframes and quality metrics on a consistent basis
- Perform all other related duties as assigned
Qualifications
- 3 years + experience in a credentialing role (DME, Audiology or Medical device background preferred)
- Ability to develop and manage credentialing independently
- A willingness to learn, take initiative and be resourceful
- A bias for action and pragmatic solutions
- Detail and results-oriented, ability to manage and prioritize requests, and effectively communicate
- The ability to be flexible in an ambiguous and dynamic environment
- Ability to solve problems, and establish trust
- Demonstrated skills in problem solving, analysis and resolution.
- Must be able to function independently, possess demonstrated flexibility in multiple project management capabilities.
- Must comply with HIPAA rules and regulations.
- Demonstrated, extensive knowledge of state licensing requirements, primary source verifications as well as credentialing database maintenance.
- Working knowledge ofpayer credentialing rules, portals and regulations preferred.
- CPCS Certification is a plus