Insurance Credentialing Specialist - TEMPORARY

Job Title: Insurance Credentialing Specialist - Temporary

Industry: Medical Supply

Duration: TEMP – 320 hours estimated. Until project is completed

Hours: Monday-Friday 9AM-5PM

Location: Honolulu, HI

Parking: Not Provided

Pay Rate: $18/hour

Bill Rate: $32.30

Description:

This company is a proud provider of medical supplies to the local people of Hawaii. The company is dedicated to providing orthopedic, pulmonary, mobility and women’s health products for over 20 years. They are a network provider for a majority of Hawaii’s health insurance companies.

SSOH Internal Creation of JD. NOT POC GENERATED

Job Title: Insurance Claims Examiner and Credentialing Specialist - Medical Device Sales Company Job Summary: We are actively seeking a versatile and detail-oriented professional to join our team as an Insurance Claims Examiner and Credentialing Specialist in the dynamic field of medical device sales. This role combines expertise in processing insurance claims with the essential responsibilities of credentialing to ensure a smooth and compliant operational workflow. The successful candidate will play a pivotal role in optimizing revenue cycle processes and ensuring our sales representatives are appropriately credentialed. Responsibilities: Insurance Claims Processing: Review and process insurance claims submitted by the sales team for medical devices. Verify the accuracy and completeness of claim documentation. Collaborate with insurance carriers to resolve any discrepancies and facilitate timely claim adjudication. Claim Documentation and Record Keeping: Maintain organized and up-to-date records of all insurance claims, ensuring compliance with industry standards. Document and track claim status, payments, and any denials or rejections. Credentialing Process Management: Oversee the credentialing process for sales representatives, ensuring alignment with company policies and regulatory requirements. Collect and verify credentials, licenses, and certifications to maintain compliance. Communication: Communicate with insurance providers, sales representatives, and internal stakeholders to address claim inquiries and resolve issues. Collaborate with sales and customer service teams to gather necessary information for claims processing. Compliance and Regulation: Stay informed about changes in insurance regulations, coding, and billing practices. Ensure that all claims processing and credentialing activities adhere to relevant laws and industry standards. Quality Assurance: Conduct regular audits of claims and credentialing processes to ensure accuracy and compliance. Implement corrective actions as needed to address identified issues. Collaboration: Collaborate with the finance, sales, and credentialing teams to streamline processes and enhance overall efficiency. Provide support to sales representatives in addressing insurance-related matters. Qualifications: Bachelor's degree in a relevant field or equivalent work experience. Proven experience in insurance claims processing and credentialing within the medical device or healthcare industry. Strong understanding of insurance billing, coding, and reimbursement practices. Familiarity with regulatory requirements related to medical device sales and insurance. Excellent organizational skills with meticulous attention to detail. Effective communication and interpersonal skills. Ability to work independently and collaboratively in a fast-paced environment. Proficient in using relevant software and Microsoft Office applications. This combined role as an Insurance Claims Examiner and Credentialing Specialist offers a unique opportunity to contribute to the financial success and compliance of our medical device sales operations. If you are passionate about optimizing revenue cycles, ensuring compliance, and thrive in a dynamic environment, we encourage you to apply.

Education: High School Diploma

Experience: Medical Insurance Credentialing experience preferred

Specific Skills: Microsoft Office, Word, Excel experience, prioritize, multi-task and have an investigatory mindset to troubleshoot during active alarms. Type 35 words per minute.

Specialized Knowledge: Some Training will be provided

Working Conditions: works in a secured facility, air conditioned within the office. Seated for majority of the work shift.

ID# 1673929

All offers are contingent upon the successful completion of background and reference checks. In addition, the following health screens are required:

• Must show proof of being fully vaccinated against COVID-19 unless a reasonable accommodation is approved. If partially vaccinated, or approved for a vaccine exemption, employees must comply by submitting weekly negative test results from an approved COVID-19 test (PCR or NAAT).

Interested Applicants: Please visit us online at www.staffingsolutionsofhawaii.com to view additional positions. Applications will only be reviewed for applicants currently living in the state of Hawaii and who are available for an interview with Staffing Solutions. #SSOH

Why work with Staffing Solutions of Hawaii:

• We are a local, award winning, and growing privately owned agency in business for 25 years

• Employees enjoy competitive pay, stimulating careers, and excellent growth opportunities!

• We have over 120 job positions including full-time, part-time, and internship opportunities inclusive with medical benefits options

• We partner with 100+ organizations in Hawaii, such as Kaiser Permanente, Bank of Hawaii, Hawaiian Airlines, Hilton Grand Vacations, KHON 2 News and many more!

We are proud to be an Equal Employment Opportunity and Affirmative Action employer, including females, minorities, protected Veterans and those with disability.