Credentialing Specialist

Job Description: Credentialing Specialist Responsible to: Director of Credentialing Services Location: Rhode Island Under the direction of the Director of Credentialing Services, the Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing, and privileging process for all medical providers. This is a full-time position with benefits.

Essential Duties and Responsibilities

Complete provider payer enrollment credentialing and re-credentialing applications; monitors applications and follows-up as needed. Process applications for initial appointment and reappointment of privileges. Maintains strict confidentiality of provider information. Provides cross-coverage of duties assigned to credentialing administrative assistant.

Perform other duties as assigned by Director to meet department needs.

Requirements

Bachelor’s Degree preferred or relevant experience. Two years of relevant credentialing experience preferred. Excellent data entry skills. Excellent organizational skills. Excellent verbal and written communication skills. Must be able to work independently with minimal supervision. Must be able to work in fast paced, deadline driven environment.

Flexibility to travel between all Rhode Island and Massachusetts office sites if/when necessary. Ability to work in Microsoft Office and proprietary credentialing software. Ability to establish and maintain effective working relationships with providers, management, staff and external contacts. #indhp