Credentialing Specialist

We are looking for a skilled Credentialing Specialist to support provider credentialing processes. This contract position involves ensuring compliance with regulations while managing credentialing applications and provider documentation. The ideal candidate will excel in maintaining accurate records, coordinating with multiple departments, and adhering to local, state, and federal standards.

Responsibilities:

• Maintain a comprehensive database of provider credentials, licenses, certifications, training, immunizations, and affiliations.
• Assist medical professionals with enrollment in various insurance plans and networks.
• Verify the accuracy and validity of submitted documents, including liability and eligibility information.
• Ensure compliance with all relevant regulations, including state and federal standards, for credentialing and licensing.
• Collaborate with departments to facilitate onboarding, credentialing, privileging, and reappointment processes.
• Prepare, update, and submit credentialing applications, policies, and procedures for internal and external use.
• Manage credentialing submissions for hospital privileges and payor affiliations.
• Support the billing department with credentialing-related tasks as needed.
• Perform additional duties as assigned to ensure smooth operations.