What are the responsibilities and job description for the Credentialing Specialist position at The Emergency Group?
Overview
We are seeking a detail-oriented and organized Credentialing Specialist to join our team. In this role, you will be responsible for ensuring that healthcare providers meet the necessary qualifications and standards to deliver quality care.
Responsibilities
- Responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, commercial payors, Medicare and Medicaid.
- Audits applications for accuracy and completeness
- Review, verify, and maintain credentials of healthcare providers, including education, training, and professional experience
- Maintain accurate records of all credentialing documentation and ensure compliance with regulatory requirements.
- Communicate with healthcare providers to gather necessary information and resolve any discrepancies in their credentials
- Responsible for monitoring application progress and following up with payors as needed until confirmation of "in network" status has been received
- Responsible for revalidation requests issued by government payors
- Stay updated on changes in medical terminology, standards, and regulations related to credentialing practices
- Assist in the development and implementation of policies and procedures related to credentialing
- All other duties as assigned.
Skills
- Familiar with provider credentialing and recredentialing requirements
- Excellent attention to detail and organizational skills
- Strong communication skills, both written and verbal, to effectively interact with healthcare professionals
- Proficient in using computer systems and software for data entry and record management
Qualifications
- High school diploma and a minimum of 2 years related experience preferred; or at least 4 years related experience and training; or an equivalent combination and work experience considered.
- Strong knowledge of Microsoft Office programs
- Strong communication skills, both written and verbal, to effectively interact with healthcare professionals
- Proficient in using computer systems and software for data entry and record management
Benefits
- Ability to work a hybrid schedule after the probationary period
- Family health insurance coverage
- Quarterly bonuses
- PTO
- 13 holidays per year
- Free parking
- 401 k after 1 year of employment
Job Type: Full-time
Pay: $18.00 - $20.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Flexible spending account
- Free parking
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Experience:
- credentialing: 1 year (Required)
Ability to Commute:
- Honolulu, HI 96813 (Required)
Ability to Relocate:
- Honolulu, HI 96813: Relocate before starting work (Required)
Work Location: In person
Salary : $18 - $20