Credentialing Specialist

  • Full-time
  • Referral Bonus Eligible: No
  • Department: Medical Service

Company Description

Founded in 1948, Norco is headquartered in Boise, Idaho and has more than 70 branches in Idaho, Montana, Oregon, Nevada, Washington, Utah and Wyoming. As a family and employee owned company we operate the nation's largest independent gas manufacturer/distributor of welding, safety, medical equipment and supplies. Norco is proud to be among the thousands of privately-owned businesses nationwide that offer their employees a meaningful stake in the business through employee stock ownership (ESOP).

At Norco we share a common mission: "Serving You Better." Treating customers, suppliers and each other with respect and dignity is our top priority. We work hard every day to serve others and create rich lives for our employees, their families, and the communities where we work and live.

Job Description

Norco is currently seeking an individual to fill our Credentialing Specialist. The Credentialing Specialist will be responsible for working closely with department personnel concerned with monitoring, establishing, and improving credentialing systems, procedures, and methods and forms with a view towards ensuring compliance with Norco processes and achieving uniformity and promoting operating efficiency. The role is also responsible for all aspects of the credentialing and re-credentialing of health care providers.Other responsibilities include, but are not limited to:

  • Work with medical accounts receivable administrators in order to ensure insurance credentialing data is up to date for billing purposes (TIMs, Billing Clearinghouse, etc.)
  • Ensure all payor credentialing is in place when establishing new branch locations and/or address changes.
  • Receives, processes, and tracks all initial credentialing and re-credentialing applications.
  • Collects all relevant information from the provider, provider’s malpractice insurer, National Practitioner Data Bank (NPDB), and other sources as deemed appropriate.
  • Manages and maintains database and provider files including data entry, status updates, and reporting.
  • Process approval, denial, or termination letters.
  • Manages physician and allied health professional termination process contacting hospitals and other pertinent organizations to remove providers who leave the practice.
  • Maintains database and necessary documentation.
  • Maintains strict level of confidentiality.
  • Maintains knowledge of current health plans and agency requirements for credentialing providers.
  • Perform other tasks as assigned or needed
  • Stay informed of and adhere to company policies and procedures

Qualifications

  • High school graduate or equivalent, college degree preferred
  • Previous experience with insurance contracting preferred
  • Knowledge of current health care and insurance landscape (strong vision for health care initiatives that will impact our business)
  • Database management skills including querying, reporting and document generation 
  • Ability to analyze, interpret and draw inferences from research findings, and prepare reports
  • Strong attention to detail 
  • Strong verbal and written communication skills 
  • Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization

Additional Information

Norco offers a competitive compensation/benefit package, including:

  • Employee Stock Ownership Plan (ESOP)
  • Health, Vision and Dental Insurance
  • Health Savings Account (HSA) 
  • Medical and Dependent Care Flex Accounts (FSA)
  • Life Insurance provided at no cost to employee by Norco through United Heritage
  • Supplemental Accident, Disease, and Life Insurance through Colonial Life Insurance
  • Employee Tuition Reimbursement
  • 401(k) with Employer Matching
  • Wellness Program
  • Employee Discount on products sold by Norco

    Norco, Inc is an Equal Opportunity/Affirmative Action Employer
    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

    Norco, Inc is a drug-free workplace. 

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