Credentialing Specialist

Credentialing Specialist

We are currently seeking a Credentialing Specialist to join BCHP! This position will be a hybrid on-site and remote position at BCHP's Valhalla, NY location. This position will also require travel to additional BCHP sites as needed. Salary approx. $65,000-$75,000, negotiable based on experience.

Job Description/Role Purpose:

The Credentialing Specialist is a professional who verifies and maintains credentials for licensed professionals. The role is responsible for reviewing applications, credentials, verifying qualifications, certifications, licensure, and other credentials, ensuring that information is up to date and accurate. The Credentialing Specialist also handles the administrative functions associated with the credentialing process, such as data entry and records management. The role is responsible for the maintenance and accuracy of all credentialing software.

Credentialing Specialist Duties

• Oversees credentialing and recredentialing of healthcare providers
• Maintains and updates provider records
• Performs primary source verifications
• Reviews applications for completeness and accuracy
• Verify the accuracy and completeness of provider applications, ensuring that all required documents are submitted
• Maintain accurate and up-to-date electronic and hard copy files of all credentialing documentation
• Communicate with providers to address any discrepancies or missing information
• Monitor expiring licenses and credentials, proactively initiating the renewal process to avoid any disruption in services
• Provide support and guidance to internal staff regarding credentialing and privileging processes
• Coordinates and schedules site visits as needed
• Creates and maintains reports for provider data and credentialing activities

Job Skills and Experience

• Bachelor's degree in a health-related field or equivalent experience
• Experience in medical credentialing, health care administration, or related field
• Minimum of 1 year of experience in credentialing or provider enrollment (NY/CT a plus)
• Exceptional organizational and time management abilities
• Effective communication and interpersonal skills
• Excellent attention to detail and ability to work with complex documents
• Ability to work independently and collaboratively with a team
• Proficient in Microsoft Office Suite
• Ability to manage multiple projects
• Knowledge of credentialing process and regulations
• MUST have own transportation and be willing to travel within the Hudson Valley region of New York and Fairfield County, Connecticut. This role requires about 25% travel.
• Certified Provider Credentialing Specialist (CPCS) highly desired but not required
• Knowledge of contract software databases a plus

BCHP will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.