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Credentialing Specialist

Posted: November 09, 2023
Salary:US$18.00 - US$22.00 per hour
Job type: Contract
Discipline:Revenue Cycle
Work Location:On-site

Job description


  • This person will be responsible for managing and maintaining provider credentialing and enrollment processes to ensure compliance with regulatory standards and policies
  • Process provider credentialing and re-credentialing applications according to established guidelines and timelines
  • Verify provider information including education, training, licensure, and certification
  • Monitor and track credentialing and re-credentialing status to ensure timely completion and compliance with regulatory standards
  • Maintain accurate and complete provider credentialing and enrollment records in accordance with regulatory requirements
  • Communicate with providers and third-party payers to obtain missing or incomplete information
  • Coordinate with internal departments and external organizations to ensure timely processing of provider enrollment applications
  • Respond to inquiries from providers, payers, and other stakeholders regarding credentialing and enrollment status
  • Monitor changes in regulatory requirements related to provider credentialing and enrollment and ensure compliance
  • Identify and implement process improvements to enhance the efficiency and accuracy of credentialing and enrollment processes
3-5 Must Have Skills/Qualifications
  • 2-3 years of experience in medical credentialing and enrollment
  • Proficient in Microsoft Office applications, including Word, Excel, and Outlook
  • MyPrint and Excel assessment must be attached to the sub
  • Must be fine with making outbound calls
Nice to Have Skills
  • Verifiable experience
  • Athena EMR experience
  • Medicare experience