Company: LifeScan Labs
Posted on: May 14, 2022
The Credentialing Administrator is responsible for completing and
applications, enrollment packets, and maintains credentialing
status with government and
commercial payers. The Administrator ensures in-network status with
contracted payers remains
active to minimize risk to revenue loss, out-of-network payment
reductions or authorizations.
Organizes and maintains payer contract agreements, fee schedules,
and credentialing records by
payer for Lifescan Labs.
Essential Job Functions:
--- Submits initial credentialing applications, enrollment packets,
and processes re-credentialing
applications timely and accurately to minimize impact on
out-of-network payments, revenue loss,
and surprise billing.
--- Reviews payer mix from clients and compares to Lifescan Labs
payer mix. Initiates contracting
process for Director.
--- Maintains accurate detailed records of all contracting and
credentialing work in addition to emails
and/or conversations with payers, networks, and government
--- Maintains accurate Lifescan Labs profile on CAQH, PECOS, NPPES,
and CMS databases.
--- Processes credentialing paperwork or electronic submissions and
credentialing status with all payers.
--- Ensures contracting, credentialing, and re-credentialing
records are accurate. Modifies records as
appropriate to maintain accuracy of documents.
--- Reviews credentialing or out-of-network denials and follows up
with payer to resolve payment
issue or requests a contract.
--- Actively manages payer websites as administrator and assigns
logins to assure HIPAA
compliance. Maintains records of all logins assigned and effective
--- Supports the Supervisor Cash Applications with managing and
updating payer documents or EDI
forms transitioning payments to ACH and electronic 835s or to bank
--- Enters, modifies, and validates master file data for all
insurance payers in the revenue cycle
system. Utilizes technology as available to load validated data
--- Supports Director by uploading and maintaining payer fee
schedules master file data within the
revenue cycle system. Utilizes technology as available to upload
validated data electronically.
--- Partners with Revenue Cycle, Sales, or Operations Management on
--- Remains current with trends, regulatory requirements, and
business strategies related to the
payer relations and revenue cycle.
--- Operates in compliance with all local, state and Federal laws
as well as policy and compliance
--- All other duties as assigned.
Education and Experience:
--- Bachelor's Degree in healthcare, business, or related field
--- 3+ years-experience in payer relations, payer contracting,
provider enrollment, or credentialing.
--- RHIA or RHIT preferred.
Key Job Competencies:
--- Microsoft Office skills - Outlook, Excel, and Word.
--- Expert in professional credentialing, provider enrollment, CAQH
Proview, and NPPES I&A
--- Ability to interpret and apply third party payer credentialing
requirements via online or forms.
--- Demonstrated experience auditing and maintaining detailed
provider records and payer
--- Detail oriented with a high level of organization, analytical,
and problem-solving skills.
--- Ability to work autonomously and efficiently within designated
timeframes or deadlines in a fast paced environment.
--- Communicates effectively orally and in writing with all levels
of the organization.
--- Customer service orientation
Keywords: LifeScan Labs, Skokie , Credentialing Administrator, Other , Skokie, Illinois
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