What are the responsibilities and job description for the Credentialing Specialist for Professional Billing position at Affiliates in Behavioral Health?
Job Overview
The Credentialing Specialist plays a crucial role in ensuring that healthcare providers meet the necessary qualifications and standards required for practice within a medical office or managed care environment. This position involves verifying credentials, maintaining accurate records, and ensuring compliance with regulatory requirements. The ideal candidate will possess a strong understanding of medical terminology and the credentialing process, contributing to the overall efficiency and integrity of the healthcare organization.
Duties
- Conduct thorough verification of healthcare providers' credentials including education, training, licensure, and work history.
- Maintain up-to-date records in compliance with organizational standards and regulatory requirements - CAQH knowledge a must.
- Collaborate with various departments to facilitate the credentialing process and resolve any discrepancies or issues.
- Monitor expiration dates of licenses and certifications, ensuring timely renewals.
- Assist in preparing reports for internal audits and external regulatory agencies.
- Stay informed about changes in credentialing standards and managed care regulations to ensure compliance.
Skills
- Strong knowledge of medical terminology to effectively communicate with healthcare professionals.
- Familiarity with credentialing standards and processes within a medical office setting.
- Experience working within managed care environments is a plus.
- Excellent organizational skills with attention to detail to maintain accurate records.
- Strong communication skills to interact with providers, staff, and regulatory bodies effectively.
- Ability to work independently as well as part of a team in a fast-paced environment.
Job Types: Full-time, Part-time, Contract
Pay: From $30,000.00 per year
Expected hours: 20 – 40 per week
Benefits:
- Paid time off
Experience:
- credentialing: 1 year (Required)
Ability to Commute:
- Berea, OH 44017 (Required)
Ability to Relocate:
- Berea, OH 44017: Relocate before starting work (Required)
Work Location: Hybrid remote in Berea, OH 44017
Salary : $30,000