Credentialing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with medical providers, hospitals, insurance companies, operations leaders, and other relevant parties to ensure proper credentialing of providers.

• Oversee the credentialing processes for hospitals and financial aspects related to both new hires and current providers.

• Manage credentialing documentation, communication, monitoring, and adherence to credentialing standards.

• Keep updated on credentialing and recredentialing requirements for various client groups.

• Request, assess, and validate credentialing applications alongside supporting documentation.

• Develop and maintain comprehensive databases containing provider information and credentialing records.

• Track provider license and certification expiration dates to guarantee timely renewals.

• Inform providers and administration about impending expirations and necessary documentation requests.

• Work in conjunction with hospitals, insurance companies, and other stakeholders to provide necessary information and monitor credentialing advancement.

• Offer status reports to operations leaders, providers, and other involved parties.

• Address and resolve issues while escalating matters as needed.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• A High School Diploma or GED is required.

• Previous administrative experience within a healthcare setting is essential.

• Experience in medical credentialing is preferred.

• Proficiency with MS Outlook, Word, and Excel is required.

• Familiarity with MS Teams and credentialing software is preferred.

• Understanding of credentialing requirements and workflows for providers across different client groups is necessary.

• Knowledge of healthcare terminology and credentialing jargon is important.

• Strong proficiency in Microsoft Office and credentialing-related software is required.

• Outstanding verbal and written communication skills are essential.

• Excellent interpersonal and customer service abilities are needed.

• Exceptional organizational skills and a keen attention to detail are necessary.

• Ability to work independently and exercise sound judgment in decision-making and problem resolution is vital.

• Capacity to manage competing priorities and perform effectively in a fast-paced environment is required.

• Skill in managing information flow in a precise and timely manner is essential.

• Ability to collaborate with professionals across various client groups and locations is necessary.

• Capability to identify and implement opportunities for improvement is important.

• A growth mindset and a team-oriented approach are desirable.

🏝️ Benefits

• Equal opportunity employer.

• Drug-free workplace.

• ADA compliance as applicable.