What are the responsibilities and job description for the Credentialing Specialist position at Wound Care Experts?
Job Summary
At WCE Specialty the Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, commercial payers, Medicare and Medicaid. Reporting to and in conjunction with the COO, the Credentialing Specialist will work closely with the COO and Billing Manager to define objectives and maintain credentialing activities.
Duties
- Conduct thorough verification of healthcare providers’ credentials, including education, training, licensure, and certifications.
- Maintain accurate and up-to-date records in the credentialing database.
- Collaborate with medical staff to ensure compliance with all relevant standards and regulations.
- Prepare and submit applications for provider enrollment with insurance companies and facilities..
- Monitor expiration dates of licenses and certifications to ensure timely renewals.
- Respond to inquiries related to credentialing processes from internal staff and external entities.
- Assist in the development and implementation of credentialing policies and procedures.
Qualifications
- Previous experience in a medical office setting is preferred.
- Familiarity with medical terminology is essential.
- Knowledge of Medtrainer platform a plus.
- Strong attention to detail and organizational skills are required.
- Excellent communication skills, both written and verbal, are necessary for effective interaction with healthcare providers and staff.
- Ability to work independently as well as part of a team in a fast-paced environment.
Experience
- 3 years of Credentialing Experience
- 5 years of medical billing with 2 years of medical billing leadership role.
- This position is crucial for maintaining the integrity of our healthcare services, ensuring that all providers are qualified to deliver high-quality care.
Job Type: Full-time
Pay: $63,042.00 - $66,386.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- credentialing: 2 years (Required)
- Medical billing: 4 years (Required)
Work Location: In person
Salary : $63,042 - $66,386