Top 84 Insurance verification specialist Jobs in Maryland

Provider Credentialing Specialist I (Remote) - Dental
CareFirst BlueCross BlueShield —Baltimore, MD
- $38,520 - $70,620 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- 401(k)
Quick Apply
Payor Clearance Specialist
Children's National Hospital —Silver Spring, MD
- $48,672 - $81,120 a year
- Full-time
- Bilingual
- Mid-level
- 3 years
- Commuter assistance
- AD&D insurance
Financial Clearance Specialist, Hybrid
University of Maryland Medical System —Linthicum Heights, MD
- Full-time
- Medical office experience
- Research
- Mid-level
6d
Medication Access Coordinator II
Johns Hopkins Care at Home —Baltimore, MD
- $20.53 - $33.90 an hour
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- 2 years
- Health insurance
- Dental insurance
Insurance Verification & Authorization Specialist
The Centers for Advanced Orthopaedics LL —Columbia, MD
- Medical office experience
- English
- Mid-level
Quick Apply
Patient Accounts Coordinator - Auth and Elig Specialist
Gilchrist Hospice Care, Inc. —Hunt Valley, MD
- $19.92 - $29.87 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Organizational skills
Quick Apply
Account Verification Specialist
RXNT —Maryland
- $19.20 - $21.60 an hour
- Full-time
- Remote
- Associate's degree
- Communication skills
- Entry level
- Disability insurance
- Health insurance
Quick Apply
Benefits & Auth for Physical Therapy
RSI-Rehabilitation Services, Inc. —Laurel, MD
- $23 - $29 an hour
- Full-time
- Medical office experience
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Senior Financial Clearance Specialist, Day
University of Maryland Medical System —Linthicum Heights, MD
- Full-time
- Medical office experience
- Mid-level
- Epic
Copy Of Referral Coordinator
AbsoluteCARE Medical Center and Pharmacy —Baltimore, MD
- Full-time
- Customer service
- Mid-level
- High school diploma or GED
- Free parking
- Disability insurance
Quick Apply
Prior Authorization Certified Pharmacy Technician
Shields Health Solutions —Baltimore, MD
- $19.45 - $22.21 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply
Leave Specialist - REMOTE
Ryder System —Annapolis, MD
- $55,000 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Analysis skills
- Disability insurance
- Health insurance
Prior Authorization Representative
Clinical Associates, P.A. —Towson, MD
- Full-time
- Medical office experience
- English
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Client Care Specialist
FYZICAL Therapy and Balance Centers —Rockville, MD
- Full-time
- Hybrid work
- High school diploma or GED
- Clinic
- Driver's License
- Opportunities for advancement
Quick Apply
Mission Partner Environment T&E Engineer
Agile Defense —Fort Meade, MD
- $130,000 - $145,000 a year
- Bachelor's degree
- SharePoint
- IT
- Paid holidays
- Disability insurance
Quick Apply
Referral and Authorization Specialist - Practice Support
Frederick Health —Frederick, MD
- $17.51 - $22.66 an hour
- Overtime
- Microsoft Outlook
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
7d
Medical Staff Coordinator, Day Shift, Medical Staff
Adventist HealthCare —Silver Spring, MD
- $22.64 - $30.63 an hour
- Full-time
- Microsoft Word
- Microsoft Outlook
- Hospital
- Free parking
- AD&D insurance
Revenue Cycle Specialist
United Theranostics —Chevy Chase, MD
- $26 - $32 an hour
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Bachelor's degree
- Paid holidays
- Disability insurance
Quick Apply
2d
Benefits Specialist
HARKINS BUILDERS INC —Columbia, MD
- $70,000 - $80,000 a year
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Profit sharing
- Paid jury duty
Call Center Specialist
Healthcare For the Homeless Inc —Baltimore, MD
- $17.50 - $20.00 an hour
- Full-time
- Spanish
- HIPAA
- High school diploma or GED
Quick Apply
13d

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Provider Credentialing Specialist I (Remote) - Dental

CareFirst BlueCross BlueShield -
Baltimore, MD

Quick Apply

Job Details

Full-time
$38,520 - $70,620 a year

Benefits

401(k)

Qualifications

Customer communication
Spreadsheets
Providing information to customers
Employee relationship building
High school diploma or GED
Internal employee customer service
Stakeholder relationship building
Excel data analysis

Full Job Description

Resp & Qualifications

PURPOSE:

This role will credential practitioners for network participation with CareFirst BlueCross BlueShield and accurately maintain all provider data within the enterprise-wide Provider file to supply the organization with provider data, while ensuring compliance with regulatory, accreditation, legal and company requirements and standards.

ESSENTIAL FUNCTIONS:

Analyzes credentialing applications to perform the primary source verification of the appropriate credentials in order for a practitioner to participate in the CareFirst networks. Once verified, accepted and approved, determines the appropriate networks for participation and obtains the appropriate executed contracts to effectuate the professional relationship and structures the provider group accordingly.
Responds to external and internal inquiries regarding provider participation eligibility and criteria, participation status, credentialing, contractual status and provider file updates. Direct focus on the provider experience, providing timely resolution dependable follow-up and proactive measures to ensure successful credentialing is achieved. Professional etiquette, communications and sound decision making is required.
Maintains the provider file, the Provider Information Control (PICS) inventory workflow system and electronic provider files with updated provider information during processes, such as credentialing, recredentialing, demographic updates, terminations and all other provider file maintenance activities.
Responsible for identifying, analyzing and resolving immediate and existing provider file issues. Processes provider file inputs in accordance with applicable state laws and departmental guidelines. Verification of provider data and system release entered into the provider file database, ensuring a successful integration with the other corporate systems.
Prepares written responses to obtain incomplete or missing information and or communicates effectively telephonically.

QUALIFICATIONS:

Education Level: High School Diploma or GED.

Licenses/Certifications Preferred:

Certified Provider Credentialing Specialist (CPCS).

Experience: 3 years physician credentialing experience or health insurance/managed care operations experience in a customer service, claims, billing and enrollment, or call center environment.

Preferred Qualifications:

Bachelor Degree in Business, Healthcare Administration or related field.

Knowledge, Skills and Abilities (KSAs)

Must be proficient in the use of Excel spreadsheets, and an understanding of Pivot tables.
Excellent verbal and written communication and interpersonal skills. Ability to develop and maintain effective relationships with peers, physicians, and medical staff to create confidence, respect and dependability.
Knowledge of medical terminology.
Demonstrated proficiency utilizing reference materials and ability to follow Standard Operating procedures to reduce risk and ensure provider data accuracy and overall quality.
Ability to understand jurisdictional requirements and the legal ramifications of the credentialing and provider file maintenance processes and interpret reasoning for performing verification and/or appropriate actions.

Salary Range: $38,520 - $70,620

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

#LI-LJ1

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Refine Your Search

insurance verification specialist jobs in maryland

Provider Credentialing Specialist I (Remote) - Dental

Payor Clearance Specialist

Financial Clearance Specialist, Hybrid

Medication Access Coordinator II

Insurance Verification & Authorization Specialist

Patient Accounts Coordinator - Auth and Elig Specialist

Account Verification Specialist

Benefits & Auth for Physical Therapy

Senior Financial Clearance Specialist, Day

Copy Of Referral Coordinator

Prior Authorization Certified Pharmacy Technician

Leave Specialist - REMOTE

Prior Authorization Representative

Client Care Specialist

Mission Partner Environment T&E Engineer

Referral and Authorization Specialist - Practice Support

Medical Staff Coordinator, Day Shift, Medical Staff

Revenue Cycle Specialist

Benefits Specialist

Call Center Specialist

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