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 stakeholders to ensure successful provider credentialing.

• Oversee all facets of hospital and financial credentialing processes for both new hires and current providers.

• Manage credentialing documentation, communication, monitoring, and compliance with established credentialing standards.

• Keep up-to-date with credentialing and recredentialing requirements across each client group.

• Request, review, and validate credentialing applications along with supporting documentation.

• Develop and maintain databases containing provider information and credentialing data.

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

• Inform providers and administration of impending expirations and documentation requests.

• Work in partnership with hospitals, insurance companies, and other stakeholders to share information and monitor the credentialing process.

• Provide status updates to operations leaders, providers, and other relevant parties.

• Address issues and escalate them as necessary.

• Perform additional duties as assigned.

⛳️ Requirements

• A High School Diploma or GED is required.

• Previous administrative experience in a healthcare setting is essential.

• Experience in medical credentialing is preferred.

• Proficiency in MS Outlook, Word, and Excel is necessary.

• Familiarity with MS Teams and credentialing software is preferred.

• Understanding of credentialing requirements and workflows for providers across various client groups.

• Knowledge of healthcare terminology and jargon related to credentialing.

• Exceptional verbal and written communication skills.

• Strong interpersonal and customer service abilities.

• Proficiency in Microsoft Office and credentialing-related software.

• Excellent organizational skills and attention to detail.

• Capability to work independently and make judicious decisions in problem-solving.

• Ability to manage competing priorities and function effectively in a fast-paced environment.

• Skill in managing information flow accurately and in a timely manner.

• Ability to collaborate with professionals from various client groups and locations.

• Capacity to identify and implement opportunities for improvement.

• Possess a growth mindset and demonstrate team-oriented behaviors.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and advancement.

• Supportive work environment with a focus on team collaboration.