- Full Time/Contract
- Pasadena, CA
Our client is committed to helping ophthalmologists and optometrists realize their full potential while providing best-in-class patient care to all those in need. They are experts in the business of providing Physician ophthalmology services with years of experience in the industry, a world-class surgeon as their founder, and an unwavering commitment to helping both established practice owners and young professionals further their ophthalmology careers.
This position performs credentialing and re-credentialing activities according to company and contracted provider polices which include; CMS, Medi-Cal, health plans and IPAs (managed care)health plans. This position acts as a liaison between the provider and contracted health plans.
The manager would like someone with knowledge/experience with various payors, such as CMS, Medi-Cal, health plans and IPAs (managed care), as well as knowledge/experience credentialing Ophthalmologists.
ESSENTIAL DUTIES & RESPONSIBILITIES
- Communicating with CMS, Medi-Cal, health plans and IPAs (managed care)health plans.
- Review and analyze credentialing documents, including education, eligibility, licensure, professional work history, liability insurance and malpractice history
- Completing credentialing applications and contracts with health plans
- Working with our Ophthalmologists to complete required documentation
DESIRED QUALIFICATIONS / REQUIREMENTS
Education and Experience:
- High school graduate or equivalent.
- Minimum two (2) years related credentialing experience
- Ophthalmologist credentialing experience required
- MS Office; Excel experience required
- EMR Systems experience required
$18.00/hr – $22.00/hr
Full Time; Contract