Credentialing Specialist

Overview Join our dynamic healthcare team as a Credentialing Specialist, where your attention to detail and passion for accuracy will ensure our providers meet all licensing, accreditation, and regulatory standards. In this vital role, you will manage the credentialing process from start to finish, supporting the organization's commitment to delivering high-quality, compliant care. Your expertise will help streamline provider onboarding, maintain up-to-date credentials, and uphold the highest standards of healthcare compliance. Responsibilities Review and verify provider credentials, licenses, certifications, and educational background to ensure compliance with organizational and regulatory standards. Manage the entire credentialing lifecycle, including initial applications, re-credentialing, and ongoing monitoring. Maintain accurate and organized credentialing files in accordance with NCQA (National Committee for Quality Assurance) standards. Collaborate with managed care organizations to facilitate provider enrollment and network participation. Track expiration dates and renewal requirements to prevent credential lapses that could impact provider privileges or reimbursement. Assist in preparing documentation for audits and accreditation reviews related to credentialing processes. Communicate effectively with providers to gather necessary documentation and update records promptly. Other duties as assigned Requirements Proven experience in medical office settings or healthcare administration, with a focus on credentialing or managed care processes. Strong understanding of medical terminology and healthcare compliance regulations. Familiarity with NCQA standards and accreditation requirements related to provider credentialing. Excellent organizational skills with keen attention to detail to ensure accuracy in all credentialing activities. Ability to handle sensitive information confidentially while maintaining efficiency under deadlines. Proficiency in using credentialing software or healthcare management systems is preferred. Join us in this rewarding role where your dedication ensures our providers are fully credentialed, compliant, and ready to deliver exceptional patient care!

Pay:

$24.73 - $29.79 per hour

Work Location:

In person