Credentialing Specialist

We are seeking a highly skilled and detail-oriented Provider Credentialing Specialist to join our team. This role is crucial for ensuring the timely and accurate submission of provider applications, facilitating smooth onboarding, and maintaining compliance with all relevant regulations.

About the Role:

The ideal candidate will possess a strong background in provider enrollment and a comprehensive understanding of the credentialing process. They will be responsible for managing accounts in CAQH, Medicaid, Medicare (PECOS), and NPI portals, as well as generating and disseminating Welcome Kits for new providers.

Key Responsibilities:

• Provider Enrollment & Application Management:
• Demonstrated expertise in the end-to-end provider enrollment process.
• Proficiency in accurately completing a high volume of provider applications across various specialties and payer types.
• Ensuring timely and efficient submission of all completed applications to relevant entities.
• Tracking application statuses and proactively following up on outstanding items to expedite approval.
• Welcome Kit Generation & Contract Loading:
• Responsible for the creation and dissemination of comprehensive Welcome Kits for new providers, ensuring all necessary documentation and information is included.
• Accurate and efficient loading of provider contracts into the designated system, ensuring all terms and conditions are correctly captured.
• Application Portal Expertise:
• Extensive experience in creating and managing accounts within key healthcare application portals, including CAQH, Medicaid, Medicare (PECOS portal), and NPI.

Requirements:

• Education:
• Bachelor's Degree in Healthcare Administration, Health Information Management, Business Administration, or Public Health.
• An associate's degree combined with relevant work experience may suffice for entry-level roles.
• Experience:
• Expertise in provider enrollment and credentialing processes, ensuring ethical and accurate completion and submission of applications across various specialties and payers.
• Proficiency in managing accounts in CAQH, Medicaid, Medicare (PECOS), and NPI portals with a commitment to ethical standards in data handling.
• Familiarity with state-specific regulations and payer requirements, maintaining integrity in compliance.
• Technical Skills:
• High proficiency in Google Sheets and Google Docs, supporting a high-performance culture through efficient workflows.
• Excellent typing skills for precise data entry, contributing to operational excellence.
• Strong knowledge of operating systems, software, and browsers to uphold professional performance standards.

Benefits:

• Competitive compensation package.
• Opportunities for career growth and professional development.
• A dynamic and supportive work environment.

What We Offer:

A challenging and rewarding role in a fast-paced healthcare environment. Join our team and take the opportunity to grow your career and make a real difference in the lives of others.

Contact Us:

To learn more about this exciting opportunity, please contact us at [contact email] or [contact phone number].