Credentialing Specialist

Position Summary Pulmonary and Sleep Center of the Valley is seeking a detail-oriented and organized Hospital & Insurance Credentialing Specialist to oversee and maintain provider credentialing and enrollment processes with hospitals, health plans, and government payers. This position plays a critical role in ensuring providers remain compliant, credentialed, and able to bill efficiently across all contracted facilities and insurance networks. Responsibilities Review and complete reappointment credentialing application Collects necessary documents to ensure accuracy of all credentialing elements Identifies, analyzes adn resolves extraordinary information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners Monitors files to ensure completeness and accuracy Prepare and provides information to internal staff as appropriate Communicates clearly with providers, and Admnistration, as needed to provide timely responses upon request on a day-to-day credentialing and privileging issues as they arise Maintains professional growth and development through seminars Performs miscellaneous job-related dutiesas assigned Education and Experience Requirements Bachelors Degree Previous experience in medical credentialing, provider enrollment, or healthcare administration preferred. Knowledge of CAQH, PECOS, NPPES, Medicare, Medicaid, and commercial payer enrollment processes. Experience with hospital privileging and insurance contracting preferred. Strong organizational and follow-up skills. Minimum of 1 years' experience in credentialing preferred Proficient in Microsoft Office Suite (Word, Excel, Outlook) Information research skills Ability to use independent judgement and to manage and impart confidential information Ability to maintain confidentiality and discretion in all communications on behalf of credentialing applicant adn /or applications Advance skills in computerized spread sheeting and database management

Job Type:

Full-time Benefits:

Dental insurance Health insurance Life insurance Paid time off Vision insurance

Experience:

Microsoft Office:

1 year (Preferred)

Microsoft Word:

1 year (Preferred)

Work Location:

In person