Credentialing Specialist

Join us at Dermatology Partners, where your career flourishes alongside your health and happiness. Your future starts here-let's grow together!Discover the Benefits of Joining Dermatology Partners!No Nights or WeekendsGrowth OpportunityMedical, Dental, and Vision InsurancePTO & Paid Holiday’s401 (k) with 4% employee match-Fully Vested from day 1Company paid Life InsuranceOptions of additional Life insurance, Short & Long term disability, Critical Illness and Accident InsuranceEmployee DiscountReferral BonusEmployee Appreciation Day: Dorney Park in FallEmployee Assistance Program (EAP)Dermatology Partners is a Dermatology group with locations in Pennsylvania, Delaware, and Maryland. Our Core values are the foundation for everything we do as an organization.Our Core Values are:Grow TogetherSeize Opportunity from StruggleOutcome Over EgoCommitment to ServeDo The Right ThingCredentialing SpecialistThe Credentialing Specialist position is responsible for ensuring that healthcare providers are properly credentialed and in compliance with all regulatory and organizational standards. This role involves verifying the credentials, licensures, certifications, and background of medical professionals to maintain compliance with industry standards and legal regulations.Responsibilities include:Credential newly hired clinicians with applicable insurance payers for timely billing.Collect, Submit, & Track all necessary documentation.Process re-credentialing for existing clinicians as required by individual payers.Maintain a current, accurate database of all clinicians’ credentialing / licensure status, needs, expirations, issues, etc. Share with internal staff as applicable.Communicate & Coordinate with all levels of internal staff & external stakeholders to ensure timely & consistent qualification is met & maintained.Monitor expiring credentials to ensure ongoing compliance with regulatory guidelines.Investigate and resolve any issues that arise during the approval process.Under the direction of leadership, assist with site level enrollments or changes to contract.Other duties as deemed necessary.Requirements:2+ years working in health plan enrollment is preferredHigh attention to detail including effective communications at all organizational levelsExperience credentialing across multiple states as well as across Commercial and Medicaid payorsExperience with state Medicaid enrollment is preferredExperience working in a team environmentDemonstrated organizational skills and ability to adhere to timelinesPreferred but not necessary:Familiarity or experience with provider enrollment or medical licensingStartup experience #J-18808-Ljbffr