Buscar empleo: 76 ofertas de trabajo de desktop support en Atlanta, Georgia (noviembre 2025)

Peachtree Orthopedics

Credentialing Coordinator

hace 3 días

Atlanta

Job DescriptionJoin Our Team at Peachtree Orthopedics and Help Others "Get Better"At Peachtree Orthopedics, we're on a mission to make a difference in healthcare, and we're looking for dedicated individuals to join our team. With nine convenient offices across Greater Atlanta, we're committed to providing top-notch care and your skills and passion can make a real impact. We're not the largest practice in Atlanta, but we take pride in delivering dedicated and compassionate care to everyone who walks through our doors. If you're ready to be part of a team that values your contribution and offers room for growth, consider joining us in our mission to help others "Get Better."Our CulturePeachtree Orthopedics has a rich history of 70 years in business and has earned recognition as a Top Workplace by the Atlanta Journal Constitution for 6 consecutive years. We take pride in our family-oriented, dedicated, passionate, and hardworking culture. When you join our team, you become a part of a community that values excellence in healthcare while working in a supportive and nurturing environment.Why Choose Peachtree Orthopedics?At Peachtree Orthopedics, we offer more than a job; we offer an opportunity to be part of something extraordinary: • Limitless Growth: Propel your career with abundant professional development opportunities within our dynamic organization., • Empathetic Culture: Immerse yourself in a supportive, lively work culture that values your well-being and celebrates your contributions., • Ensure accurate and timely credentialing and subsequent submission of provider information to support appointing and claims submission., • Ensure accurate and timely data entry of provider demographics., • Perform as the point of contact for the contracted health plans, vendors, and providers., • Assist providers in obtaining insurance, privileges and/or other required credentialing and practice elements., • Remain current on Federal and State regulatory, licensure, certification & application requirements to include Medicare, DSHS, Federal and State L&I, State L&I Crime Victims programs, NPDB and HCQIA standards., • Remain current on payer requirements and Credentialing processes to include a working knowledge of NCQA and URAC accreditation standards., • Maintain professional and proactive relationships with providers, contracted payers, and physicians/clinics including troubleshooting and responding to inquiries related to enrollment process and contributing to policies and procedure updates, internal desktop procedures and workflows., • Performance trending reports related to denials and payment variance., • Analyze and collection of underpaid claims., • Process Refund request from managed care payers to ensure the request meets contractual obligations., • Analytical - Synthesizes complex or diverse information; collects and researches data; uses intuition and experience to complement data., • Continuous Learning - Assesses own strengths and weaknesses; seeks feedback to improve performance; pursues training and development opportunities; strives to continuously build knowledge and skills., • Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; uses resources effectively., • Use of Technology - Demonstrates required skills; adapts to new technologies; troubleshoots technological problems; uses technology to increase productivity; keeps technical skills up to date., • Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics., • Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments., • Communications - Expresses ideas and thoughts verbally; expresses ideas and thoughts in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods., • Cooperation - Establishes and maintains effective relations; exhibits tact and consideration; offers assistance and support to co-workers; works cooperatively in group situations; works actively to resolve conflicts., • Managing Customer Focus - Promotes customer focus; establishes customer service standards; provides training in customer service delivery; monitors customer satisfaction; develops new approaches to meeting customer needs., • Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings., • Teamwork - Balances team and individual responsibilities; exhibits objectivity and openness to others' views; gives and welcomes feedback; contributes to building a positive team spirit; puts success of team above own interests; able to build morale and group commitments to goals and objectives; supports everyone's efforts to succeed., • Written Communication - Writes clearly and informatively., • Conflict Resolution - Maintains objectivity., • Diversity - Shows respect and sensitivity for cultural differences., • Ethics - Works with integrity and principles., • Organizational Support - Follows policies and procedures; completes administrative tasks correctly and on time; supports organization's goals and values., • Adaptability - Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events., • Personal Appearance - Dresses appropriately for position; keeps self well groomed., • Achievement Focus - Measures self against standard of excellence., • Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time., • Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate plan., • Initiative - Undertakes self-development activities; seeks increased responsibilities; asks for and offers help when needed., • Innovation - Generates suggestions for improving work., • Judgment - Exhibits sound and accurate judgment., • Planning/Organizing - Uses time efficiently., • Quality - Demonstrates accuracy and thoroughness; looks for ways to improve and promote quality., • Quantity - Meets productivity standards; completes work in timely manner; strives to increase productivity; works quickly., • Associate degree in Finance, Accounting, Healthcare Administration, Business or related area or equivalent education, training and/or experience required., • Three plus years’ experience in network development including contracting experience with a combination of physicians, physician groups, hospitals and ancillaries/services and experience in underpayment analysis are required., • Working knowledge of current medical issues, trends and modifications in the laws and regulations governing clinician credentialing. Demonstrated knowledge of CMS and NCQA credentialing requirements. Working knowledge of Medicare Secondary payer as well as medical necessity requirements. Hands-on knowledge of CCI, OCE edits. Hands on knowledge of CPT, ICD-10 coding, HCPCS, revenue codes and terminology for medical billing. Hands-on knowledge of CCI, OCE edits., • Hands-on experience in physician business office account follow-up including zero payment denials resolution and underpayment variance resolution., • Healthcare Financial Management Association (HFMA) Patient Accounts and Hospital Accounting Certification; CPAR certification, Advanced CPAR or CPAM preferred. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear and frequently required to stand, walk, sit, and use hands to handle files, computers, and phones; reach with hands and arms. Frequent and regular repetitive movements required using the wrists, hands, and/or fingers. The employee will operate a keyboard, calculator, telephone, copy machine, computer and other office equipment as necessary. The employee frequently is required to move all extremities within full range of motion as well as stoop and bend at 90 degrees. The employee must occasionally lift and/or move up to 30 pounds. It is necessary to view and type on computer screens for long periods of time and to work in an environment which can be very stressful. Specific vision abilities required by this job include close vision. This is a full-time position. This position may require long hours. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Must be able to deal with aggressive, hostile, and sometimes irrational behavior of patients and family members and have the ability to respond to all patients in a calm and professional manner. Peachtree Orthopedics is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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