at Kent General Hospital in Dover, Delaware, United States
The Credentialing Specialist (BHMG) accurately maintains demographic data in the provider enrollment/credentialing software for Bayhealth Medical Group providers; completes provider enrollment applications, follows up with health plans to expedite participation approval by each health plan, assists insurance personnel with resolving provider enrollment denials, and communicates provider enrollment status to appropriate personnel. The Credentialing Specialist also works with Medical Staff Services personnel in processing credentialing requests for Bayhealth Medical Group (BMG) providers.Must have a High School Diploma or GED. Associate’s Degree or equivalent training with at least three years’ experience in a medical office setting preferred. Must have at least three (3) years’ experience in an office setting requiring well-developed spreadsheet and word processing skills. Must have intermediate level knowledge of Microsoft Office (Excel, Powerpoint, Word). Credentialing, coding and/or insurance billing software experience preferred. Must also have the following: • Medical terminology experience • Ability to collect data, problem solve, establish facts, and draw conclusions • Ability to clearly communicate, present ideas, facts, and clinical information • Proficiency in reading, writing, and speaking English.