Chart Auditor/Credentialing Specialist

Job Overview We are seeking a detail-oriented and energetic Chart Auditor/Credentialing Specialist to join our dynamic healthcare team. In this pivotal role, you will ensure the accuracy and completeness of medical records, verify provider credentials, and uphold compliance with industry standards. Your expertise will help maintain the integrity of clinical documentation and credentialing processes, supporting high-quality patient care and regulatory adherence. This position offers an exciting opportunity to contribute to a fast-paced environment where precision, efficiency, and compliance are paramount. Duties Review and audit clinical charts to verify completeness, accuracy, and adherence to documentation standards. Validate provider credentials against licensing boards, professional organizations, and NCQA (National Committee for Quality Assurance) standards. Ensure all credentialing documentation is current, accurate, and compliant with managed care requirements. Collaborate with healthcare providers to resolve discrepancies or missing information in medical records. Maintain detailed logs of audit findings, credentialing statuses, and compliance reports. Assist in preparing documentation for accreditation audits and regulatory reviews. Support continuous process improvements by identifying areas for enhanced accuracy and efficiency in chart review and credentialing workflows. Skills Strong understanding of managed care processes and requirements. Previous experience working in a medical office or healthcare setting is highly preferred. Proficiency in medical terminology to accurately interpret clinical documentation. Familiarity with NCQA standards and other industry accreditation criteria. Excellent attention to detail with a keen eye for discrepancies or errors in records. Effective communication skills for collaborating with providers, staff, and external agencies. Ability to organize multiple tasks efficiently while maintaining high levels of accuracy. Join our team to play a vital role in safeguarding the integrity of healthcare documentation while supporting compliance with industry standards!

Benefits:

Employee discount Life insurance Paid time off

Work Location:

In person