Senior Credentialing Specialist

Job Title

Daily tasks and responsibilities include, but not limited to:

• Accurately complete payer enrollment and facility appointment applications for providers.
• Provides support and assistance for new practice setup as needed.
• Track progress of outstanding applications and communicate with provider relation representatives ensuring enrollment completion.
• Maintains accurate and current information in the provider records which includes credentialing software database and in provider electronic folders.
• Maintains credential files in an orderly and current manner.
• Provides research and administrative support for special projects.
• Ensures HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities.
• Other duties may be assigned from time to time.

Important Note: This Job Description is subject to any reasonable adjustment in accordance with the changing and developing needs of the position.

Qualifications and Requirements

• Preferably a college graduate or at least two years of college completed.
• Minimum 3 years of experience in healthcare administration, credentialing, and provider enrollment (governmental and commercial payers) for facility-based providers.
• Minimum 1 year of experience in a healthcare revenue cycle setting.
• Familiarity with credentialing software (e.g., CAQH, CredentialStream).
• Strong written and verbal communication skills.
• Strong critical thinking skills.
• Excellent attention to detail.
• Client-service oriented.
• Highly effective team collaboration, accountable, and able to work with minimal supervision.
• Proficient in email management and Microsoft Word and Excel applications.
• Highly motivated self-starter.
• Organized, able to set priorities, and meet deadlines.
• Team player who supports department and company goals and policies.
• Degrees or coursework related to the medical field are a plus.