veterans | Credentialing Specialist - Change Healthcare in Tonawanda, NY

Credentialing Specialist - Change Healthcare

  • Change Healthcare
  • 2225 Military Rd
  • Tonawanda, NY 14150
  • Full-Time
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Transforming the future of healthcare isnt something we take lightly. It takes teams of the best and the brightest, working together to make an impact.

As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.

Here at Change Healthcare, were using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life.

If youre ready to embrace your passion and do what you love with a company thats committed to supporting your future, then you belong at Change Healthcare.

Pursue purpose. Champion innovation. Earn trust. Be agile. Include all.

Empower Your Future. Make a Difference.

Responsibilities include but are not limited to:

  • Assist with creating and distributing department wide communications or pathways, notifying staff of updated insurance guidelines/processing information related to credentialing and the processing of credentialed providers
  • Participate in meetings with Payers, internal departments, Client contact(s) and BPS Management, etc. to address trends and or issues in denials or unprocessed claims due to credentialed/non-credentialed providers
  • Compile and analyze information identified by A/R Follow Up Supervisors of current and/or potential billing issues specific to credentialed /non-credentialed providers
  • Presenting data to appropriate parties and partnering to develop resolutions
  • Handles escalated client issues that include but are not limited to dissatisfied client contacts that may require additional system or technical knowledge
  • Process credentialing and updated credentialing applications or enrollments of health care providers
  • Assist with entering, updating, maintaining NPI and any other applicable provider numbers into the system
  • Assist with application review, preparing verification letters, and maintaining database.
  • Qualified candidates will possess a high school degree or equivalent; 2-3 years of additional schooling or related experience preferred and a minimum of 1 year A/R Follow Up experience required. Excellent verbal and written communication skills with strong attention to detail are required.

  • In depth knowledge of various insurance policies and procedures related to claim adjudication and payment processes as related to the credentialing process.
  • In depth knowledge of provider types and titles and the credentialing processes associated with each
  • Ability to work independently with minimal supervision; drives execution
  • Excellent written and oral communication skills
  • Strong attention to detail
  • Ability to maintain confidentiality
  • Represents the office/Organization in a positive manner; supports and encourages strong morale and spirit in his/her team.
  • Can marshal resources to complete tasks and orchestrate multiple activities at once to accomplish goals
  • Ability to solve difficult problems in a timely manner with efficient resolutions
  • Can negotiate skillfully in tough situations; can win consensus without damaging relationships
  • Works well with others; ability to work with and communicate with individuals of varying disciplines.
  • Moderate to high level knowledge of Excel and Word
  • Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

    Equal Opportunity/Affirmative Action Commitment

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.



    * The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.