Credentialing Specialist

• Coordinate provider credentialing process and ensure credentialing deadlines are met. 

• Research and solve credentialing/re-credentialing delays & issues with enrollment  

• Manage confidential information of internal staff  

• Ensure demographic updates are reviewed and verified  

• Ensure the database is kept accurate and updated. 

• Maintain necessary logs, lists, records, and current documentation required for physician/provider credentialing and re-credentialing 

• Prepare documents for Credentialing Committee review. 

• Outreach to provider for information verification and other inquiries 

• Provide productivity and issues reports for Management. 

• Remain current on policies affecting provider credentials and enrollment  

• Other duties as assigned. 

QUALIFICATIONS: 

• Associates/Bachelor’s Degree, and/or equivalent work experience. 

• A minimum of three (3 ) years of credentialing experience. 

• Certified Provider Credentialing Specialist, preferred. 

• Credentialing in a Healthplan setting, preferred. 

• Microsoft Office Suite proficient 

• Highly organized. 

• Able to multitask efficiently and effectively. 

• Solid problem solving and time management skills. 

Additional Salary Detail  

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member’s base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).