Provider Credentialing Specialist
12 hours ago
Job Summary:
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.
Key Responsibilities:
- Provider Enrollment & Application Management:
- 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), and NPI portals.
Required Skills & Qualifications:
- Bachelor's Degree in a relevant major such as Healthcare Administration, Health Information Management (HIM), Business Administration, or Public Health.
- Associate's degree combined with relevant work experience may suffice for entry-level roles.
- Expertise in provider enrollment and credentialing processes, ensuring ethical and accurate completion and submission of applications.
- Proficiency in managing accounts in CAQH, Medicaid, Medicare (PECOS), and NPI portals with a commitment to ethical standards in data handling.
Benefits:
This role demands a detail-oriented professional with a strong ethical foundation, technical proficiency, and a drive for performance excellence in credentialing. Familiarity with state-specific regulations and payer requirements is a plus.
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