Medical Credentialing Specialist

Job Description

Job Description

We are seeking a  Medical Credentialing Specialist  for our client in the Bronx, NY for a contract to hire position. 3+ years experience in credentialing, with Certified Provider Credentialing Specialist being preferred.

 

JOB PURPOSE:

Coordinate all credentialing activities to ensure provider participation with the Organization. Ensure provider compliance with credentialing standards.

 

JOB RESPONSIBILITIES:

- Coordinate provider credentialing process to increase efficiency and ensure that credentialing deadlines are met.

- Research and solve credentialing/re-credentialing delays & issues with enrollment in a timely manner.

- Manage confidential information of internal staff (Physicians, Nurse Practitioners).

- Ensure demographic updates are reviewed and verified for processing.

- Ensure the database is kept accurate and updated.

- Maintain necessary logs, lists, records, and current documentation required for physician/provider credentialing and re-credentialing to ensure requirements are met in a timely manner.

- Prepare documents for Credentialing Committee review.

- Provide productivity and issues reports for Management.

- Remain current on policies affecting provider credentials and enrollment processes.

- Perform other responsibilities as assigned.

 

QUALIFICATIONS:

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

 

Experience:

- A minimum of three (3+) years of credentialing experience.

- Required: Provider Credentialing

- Preferred: Credentialing in a Healthplan setting.

- Microsoft Office/Suite Proficient (Excel, Outlook, Word, etc.)

- Highly Organized.

- Able to multitask efficiently and effectively.

- Solid problem solving and time management skills.

- Have the ability to review and draft correspondence in email and word processing systems.

- Professional, Friendly, and Skillful Communication Skill Set.

 

License: None Required, Certified Provider Credentialing Specialist is Preferred.

 

Please note: This position is not open to 3rd party c2c agencies. No visa sponsorship provided. All applicants must have permanent US work authorization and not require sponsorship now or in the future.