Credentialing Specialist

Louisiana Orthopaedic Specialists

Credentialing Specialist

We are seeking a detail-oriented Credentialing Specialist to join our healthcare team, focusing on orthopaedic provider credentialing. This remote position plays a crucial role in maintaining the highest standards of patient care and regulatory compliance by managing the credentialing process for our orthopaedic healthcare providers.

The Virtual Credentialing Specialist will ensure the accurate verification and maintenance of healthcare provider credentials through:

Managing the comprehensive credentialing lifecycle for providers, including initial applications, reappointments, and ongoing monitoring of compliance requirements
Conducting thorough primary source verification of medical education, training, licensure, and board certifications
Maintaining detailed digital records and updating credentialing databases with precision and timeliness
Coordinating with insurance payers for provider enrollment and network participation
Proactively tracking and managing credential renewal deadlines to ensure continuous compliance
Investigating and resolving credentialing discrepancies through appropriate channels
Generating regular status reports and compliance updates for leadership review

Required Qualifications

Minimum of 2 years' experience in healthcare credentialing
Demonstrated proficiency in electronic credentialing management systems
Strong understanding of healthcare regulations and accreditation standards
Excellent organizational skills with exceptional attention to detail

Preferred Qualifications

NAMSS Certification (CPCS or CPMSM)
Experience with Louisiana State Board of Medical Examiners (LSBME), Louisiana Board of Nursing and Pharmacy
Demonstrated proficiency with Louisiana Medicaid and MCO credentialing requirements
Familiarity with the Council for Affordable Quality Healthcare (CAQH)
Experience with Louisiana hospital privileging systems
Understanding of Louisiana Workers' Compensation Medical Treatment Guidelines for orthopaedic care
Familiarity with the Louisiana Uniform Credentialing Program

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Vacancy posted 1 day ago

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