What are the responsibilities and job description for the Credentialing Administrator position at Bay Dermatology and Cosmetic?
Description
We are seeking a detail-oriented and experienced Credentialing Administrator to join our dermatology practice. The Credentialing Administrator will be responsible for managing and maintaining the credentialing and re-credentialing process for all healthcare providers, ensuring compliance with regulatory and insurance requirements. The ideal candidate will have a strong understanding of credentialing procedures, excellent organizational skills, and the ability to communicate effectively with providers, payers, and internal staff.
Requirements
Key Responsibilities:
- Oversee and manage the credentialing and re-credentialing processes for physicians, nurse practitioners, and other healthcare providers within the practice.
- Maintain up-to-date provider files, ensuring all documentation is current and compliant with federal, state, and payer-specific requirements.
- Prepare and submit applications for provider enrollment with commercial and government insurance plans (Medicare, Medicaid, private insurers, etc.).
- Track and monitor the status of credentialing applications, following up as needed to ensure timely approvals.
- Maintain credentialing databases and software, updating records as necessary.
- Coordinate with providers and practice administrators to ensure timely submission of required documentation.
- Monitor and ensure compliance with regulatory bodies, such as The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), and the Centers for Medicare & Medicaid Services (CMS).
- Respond to inquiries regarding credentialing status and requirements.
- Assist in audits and provide reports on credentialing activities as needed.
Qualifications:
- Associate’s or Bachelor’s degree in healthcare administration, business administration, or a related field (preferred).
- Minimum of 2-3 years of experience in medical credentialing, preferably in a Dermatology or multi-specialty practice.
- Knowledge of provider enrollment procedures with Medicare, and commercial payers.
- Familiarity with credentialing databases and software systems.
- Strong understanding of compliance regulations and industry standards.
- Excellent attention to detail and organizational skills.
- Strong communication and problem-solving abilities.
- Ability to work independently and manage multiple tasks efficiently.
Benefits:
- Competitive salary based on experience.
- Health, dental, and vision insurance.
- Paid time off and holidays.
- Professional development opportunities.
- Retirement plan options.
If you are a highly motivated professional with a passion for ensuring provider compliance and a commitment to excellence, we invite you to apply for this position. Please submit your resume along with a cover letter.
