Job Description

About Neolytix

Neolytix is a boutique Consulting and Management Services Organization that works with small & medium-sized healthcare providers across the United States. Our portfolio of services caters to micro verticals and is built on the expertise we have developed in enabling these practices.

Work with a company where your work can make a real impact!

We are a boutique company respected and \xe2\x9d\xa4 by our clients providing no-nonsense advice on key issues that impact them.

4.7 \xe2\xad\x90 on Google and 4.2 \xe2\xad\x90 on Glassdoor with 80% of approval rating!

Working at Neolytix

At Neolytix, you will learn to hone your Consultative skills, develop drive & leadership, balance work with family time and importantly have fun!

Complimentary Medical Coverage for your Family & dependents

Retirements Savings Plan

Life & Disability Insurance

Work with diverse team members across countries & cultures

Participate in Clubs based on your hobbies and share your passion with like minded enthusiasts

About this Position

The Credentialing and Insurance contracting Manager is responsible for maintaining active status for providers and groups with Insurance plans by successfully completing initial and subsequent credentialing and contracting applications as required by commercial payers, Medicare and Medicaid in different states of USA.

Job Responsibilities

\xc2\xb7 Maintain individual provider files and group information to include up to date information needed to complete the required government and commercial payer credentialing applications.

\xc2\xb7 Maintain internal trackers to ensure all information is accurate and logins are available and legible.

\xc2\xb7 Update each provider\xe2\x80\x99s CAQH database file timely according to the schedule published by CMS

\xc2\xb7 Complete revalidation requests issued by government payers

\xc2\xb7 Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid

\xc2\xb7 Complete re-credentialing applications for commercial payers

\xc2\xb7 Credential new providers and re-credential current providers

\xc2\xb7 Credential/ approve new and existing groups with government and commercial insurance plans.

\xc2\xb7 Coordinate with client and doctors and billing staff to identify and resolve any missing items, signatures, expiration of license or any other issues related to provider credentialing.

\xc2\xb7 Keep the clients updated on the progress of their application and scope of work.

\xc2\xb7 Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases

\xc2\xb7 Other duties as assigned

Knowledge, Skills and Abilities

\xc2\xb7 Knowledge of provider credentialing and contracting with government and commercial Insurance plans at least in one state in USA

\xc2\xb7 Experience in submitting applications for contracting and credentialing with Insurance plans.

\xc2\xb7 Excellent computer skills including Excel, Word, and Internet use

\xc2\xb7 Detail oriented with above average organizational skills

\xc2\xb7 Plans and prioritizes to meet deadlines

\xc2\xb7 Excellent management skills; communicates clearly and effectively

Experience minimum 8 years in end to end Credentialing process

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