Payer Credentialing Specialist at Plumas District Hospital

Morgantown, West Virginia, United States -

Full Time

Start Date

Immediate

Expiry Date

14 May, 26

Salary

28.74

Posted On

13 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Payer Credentialing, Provider Enrollment, Re-enrollment, Database Maintenance, Claim Denial Resolution, Insurance Verification, Billing, Healthcare Regulations, Organizational Skills, Time Management, Attention To Detail, Analytical Skills, Confidentiality, Regulatory Adherence, Collaboration, Independent Work

Industry

Hospitals and Health Care

Description

Nature and Scope Under general supervision of the Billing Supervisor, this full-time position manages the entire lifecycle of payer enrollment, credentialing, and re-enrollment of healthcare providers and facilities with Commercial and Governmental payers for Plumas District Hospital. Responsible for maintaining provider databases, ensuring accurate, timely submission of documentation to secure billing privileges and network participation. Maintains and updates facility enrollment list. PFS duties will include resolving claim denials, verifying insurance and performing billing related tasks to ensure timely and accurate reimbursement. Location We are located at 1065 Bucks Lake Road, Quincy, CA 95971. Compensation Compensation Philosophy: We have 6 pay increments on our clinical pay scales to compensate successful candidate for 6 years of relevant experience Compensation Range: $22.52- $28.74/ hour Job Status / Shift Information Full-time, benefited Remote option availabile Qualifications Experience: Minimum three (3) years’ experience in Patient Financial Services or payer credentialing. Knowledge/Skills/Abilities Strong understanding of healthcare regulations, insurance plans, and payer credentialing processes. Excellent organizational and time management skills. Strong attention to detail and analytical skills. Maintain confidentiality and adhere to regulatory guidelines. Collaborate with internal teams including provider credentialing and billing to streamline processes. Ability to work independently and perform critical work under deadlines effectively with supervisors and other staff. Ability to be flexible and function well in a fast-paced online environment. Responsibilities Act as the primary point of contact for providers regarding health plan enrollment and inquiries. Stay updated on changes in health plan enrollment regulations and credentialing standards. Develops and maintains professional and technical skills to ensure ongoing competence. Develops and maintains written instruction for each health plan requirements for provider enrollment. Maintains provider roster list for enrollment and re-enrollment purposes. Benefits / Perks Options offered to benefit eligible employees: Excellent Medical, Pharmacy, Dental, and Vision Plans Paid days for continuing education, bereavement, and jury duty Retirement Plans with 3% company contribution Voluntary Life Insurance and Long Term Disability Considerable Paid Time Off And more! PDH Benefits to review more details on current options available Perks all employees can enjoy: Inclusive and connected work environment Competitive Compensation Discounted memberships with Flight/American Medical Care Network Shift differentials paid for certain work shifts, including Holiday pay Child Care: PDH is thrilled to provide our Child Care Center services to all families in our area. Our program is operational from 7:45am to 5:15pm, Monday through Friday, and is approved for children aged 0 to 5 years. After submitting your application, our Child Care Director will get in touch with you about your acceptance into the program. Once approved, we will start the enrollment process. PDH employees take priority on our waiting list. For any additional questions please contact our Child Care Center Director at 530-283-7165 or childcare@pdh.org Why Plumas District Hospital Work in a setting with rugged canyons, crystal clear lakes, grassy meadows, trout-filled streams, fresh pine forests, and brilliant star-filled skies. This is your chance to provide compassionate care with exceptional customer service at Plumas District Hospital. With a diverse population with people from all walks of life, PDH team members provide the residents of Quincy and the surrounding area with essential health care services that are vital to this small mountain community. PDH is located in Quincy, California which is the largest community in Plumas County and has a population of 5,000 residents. Quincy is nestled against the Western slope of the Sierra Nevada mountain range and tucked in at the edge of the lush American Valley. Chico, California is 80 miles west and Reno, Nevada is 80 miles east of Quincy. Join a medical team that puts community first. Click this link https://www.pdh.org/ to learn more about PDH providers, services, and surrounding community today! Contact Information Recruiter Name/Email: Nicholas Clawson Department Phone: 530-283-7169

Responsibilities

This full-time position manages the entire lifecycle of payer enrollment, credentialing, and re-enrollment for healthcare providers and facilities with commercial and governmental payers. Responsibilities also include maintaining provider databases, ensuring accurate documentation submission, and performing Patient Financial Services duties like resolving claim denials and verifying insurance.