Credentialing Specialist

This is a fully remote position, open to applicants in Florida, +8 more states.

📋 Description

• Assist in various initiatives within the credentialing team

• Support provider enrollment processes

• Manage and maintain CAQH profiles

• Acquire and evaluate physicians’ medical licenses

• Facilitate hospital privileging procedures

• Complete and process credentialing applications efficiently

• Gather provider credentials and update both internal and external databases

• Analyze and enhance onboarding processes and workflows, incorporating automation where suitable

• Collaborate with management, physician office personnel, and physicians to fulfill credentialing tasks

• Ensure provider data remains current in credentialing databases and online systems

• Keep accurate provider rosters for insurance providers

• Monitor CAQH completion and re-attestation deadlines

• Track expirables such as medical licenses, DEA, and CDS

• Inform administration, billing, and operations about provider effective dates

• Uphold confidentiality of provider information

• Complete initial hospital and reappointment applications

⛳️ Requirements

• 0-2 years of experience in managed care credentialing, billing, and/or Medical Staff service setting

• High School Diploma or equivalent

• Prior experience in a medical office is preferred

• Familiarity with medical terminology, billing, and insurance is advantageous

• Proven abilities in problem-solving, analysis, and resolution

• Strong attention to detail

• Compliance with HIPAA rules and regulations is essential

• Highly responsive, detail-oriented, and organized

• Capability to handle a variety of tasks throughout the workday

• Collaborative team approach with colleagues

• Experience in project coordination

• Exhibits determination and initiative

• Analytical mindset and organized

• Self-motivated and capable of independent problem-solving

🏝️ Benefits

• Competitive salary

• Comprehensive health benefits

• Opportunities for professional development

• Supportive work environment

• Flexible work arrangements