Job Title: Credentialing Specialist

Job Description

Coordinate all credentialing activities to ensure provider participation with the organization. Ensure provider compliance with credentialing standards. Conduct outreach to providers for verification and request for information.

Responsibilities

• Coordinate provider credentialing process to increase efficiency and ensure that credentialing deadlines are met.
• Research and solve credentialing/re-credentialing delays and issues with enrollment in a timely manner.
• Manage confidential information of internal staff (Physicians, Nurse Practitioners).
• Ensure demographic updates are reviewed and verified for processing.
• Ensure the database is kept accurate and updated.
• Maintain necessary logs, lists, records, and current documentation required for physician/provider credentialing and re-credentialing to ensure requirements are met in a timely manner.
• Prepare documents for Credentialing Committee review.
• Outreach to providers for information verification and miscellaneous inquiries, such as provider portal access, nursing home documentation, and medical records retrieval.

Essential Skills

• A minimum of three (3 ) years of credentialing experience.
• Credentialing in a Healthplan setting (preferred).
• Microsoft Office/Suite Proficient (Excel, Outlook, Word, etc.).
• Highly organized.
• Able to multitask efficiently and effectively.
• Solid problem-solving and time management skills.
• Ability to review and draft correspondence in email and word processing systems.
• Professional, friendly, and skillful communication skill set.

Additional Skills & Qualifications

• Certified Provider Credentialing Specialist (preferred).
• Customer service experience.
• Knowledge of medical terminology.

Work Environment

The work environment includes working with various technologies and equipment. You will be expected to maintain a professional demeanor and attire appropriate for a healthcare setting. The role may involve standard office hours with the potential for some flexibility.

Pay and Benefits

The pay range for this position is $18.00 - $22.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a hybrid position in Bronx,NY.

Application Deadline

This position is anticipated to close on Apr 17, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $18 - $22