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.