Senior Credentialing Specialist

Daily tasks and responsibilities include, but not limited to:


* Accurately complete payer enrollment and facility appointment applications for providers.


* Provides support and assistance for new practice setup as needed.


* Track progress of outstanding applications and communicate with provider relation representatives ensuring enrollment completion.


* Maintains accurate and current information in the provider records which includes credentialing software database and in provider electronic folders.


* Maintains credential files in an orderly and current manner.


* Provides research and administrative support for special projects.


* Ensures HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities.


* Other duties may be assigned from time to time.

 

Important Note: This Job Description is subject to any reasonable adjustment in accordance with the changing and developing needs of the position.

Qualifications and Requirements


* Preferably a college graduate or at least two years of college completed.


* Minimum 3 years of experience in healthcare administration, credentialing, and provider enrollment (governmental and commercial payers) for facility-based providers.

 


* Minimum 1 year of experience in a healthcare revenue cycle setting.


* Familiarity with credentialing software (e.g., CAQH, CredentialStream).


* Strong written and verbal communication skills.


* Strong critical thinking skills.


* Excellent attention to detail.


* Client-service oriented.


* Highly effective team collaboration, accountable, and able to work with minimal supervision.


* Proficient in email management and Microsoft Word and Excel applications.


* Highly motivated self-starter.


* Organized, able to set priorities, and meet deadlines.


* Team player who supports department and company goals and policies.


* Degrees or coursework related to the medical field are a plus.