Provider Credentialing Specialist

We are seeking an exceptional provider credentialing professional to join our organization. The ideal candidate will possess a strong background in provider enrollment and a comprehensive understanding of the credentialing process.

• Provider Enrollment & Application Management:
  • Demonstrated expertise in the end-to-end provider enrollment process, 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 portals.
• Regional Credentialing Advantage:
  • Experience working with providers specifically in Florida will be considered a significant advantage, demonstrating familiarity with state-specific regulations and payer requirements.
• Communication & Responsiveness:
  • Maintain a high level of professionalism and responsiveness in all email communications, promptly addressing queries and providing clear, concise information to internal and external stakeholders.
• Compliance & Confidentiality:
  • Strictly adhere to all HIPAA regulations and maintain the utmost confidentiality of sensitive patient and provider information.
  • Ensure all credentialing activities are in full compliance with federal, state, and organizational guidelines.

• Excellent Communication and Interpersonal Skills:
  • Demonstrate exceptional ability to convey information clearly, concisely, and effectively, both verbally and in writing.
• Ability to Work Independently and as Part of a Team:
  • Exhibit a strong sense of initiative and self-motivation, capable of managing tasks and responsibilities autonomously with minimal supervision.
• Proficiency in Google Sheets and Docs:
  • Highly skilled in utilizing Google Sheets for data organization, analysis, and visualization, including the creation of complex formulas, pivot tables, and charts.
• Excellent Typing Skills:
  • Possess a high level of accuracy and speed in typing, significantly contributing to efficient data entry, document creation, and overall productivity.
• Comprehensive Knowledge of Computer Usage and Navigation:
  • Display a thorough understanding of operating systems, common software applications, and internet browsers.

• Bachelor's Degree in a relevant major such as Healthcare Administration, Health Information Management (HIM), Business Administration, or Public Health.
• Expertise in provider enrollment and credentialing processes.
• Proficiency in managing accounts in CAQH, Medicaid, Medicare (PECOS), and NPI portals.
• Familiarity with state-specific regulations and payer requirements, particularly in Florida.
• Technical Skills: High proficiency in Google Sheets (formulas, pivot tables, charts) and Google Docs, supporting a high-performance culture through efficient workflows.

• Clear, Professional, and Ethical Verbal and Written Communication.
• Strong Organizational and Time Management Skills.
• Ability to Work Independently and Collaborate Effectively with Team Members.
• Attention to Detail and Commitment to Quality and Accuracy.