Credentialing Specialist

Credentialing Specialist Ohana Kids And Family Kare Phoenix, AZ Job Details Full-time From $22 an hour 17 hours ago Benefits Paid time off Qualifications Accreditation standards (regulatory compliance area) Managed care eClinicalWorks Full Job Description Overview We are seeking a detail-oriented and proactive Credentialing Specialist to join our dynamic healthcare team. In this vital role, you will be responsible for managing the credentialing and re-credentialing processes for healthcare providers, ensuring compliance with industry standards and regulatory requirements. Your expertise will help maintain the integrity of provider credentials, support smooth operational workflows, and uphold the organization's commitment to high-quality patient care. This position offers an exciting opportunity to contribute to a fast-paced environment dedicated to excellence in healthcare administration. Duties Review and verify provider credentials, including licenses, certifications, and education records, to ensure accuracy and completeness Manage the credentialing workflow by collecting, organizing, and maintaining documentation in accordance with NCQA (National Committee for Quality Assurance) standards Coordinate with healthcare providers, managed care organizations, and licensing boards to facilitate timely credentialing and re-credentialing processes Monitor expiration dates of credentials and proactively initiate renewal procedures to prevent lapses in provider eligibility Ensure compliance with all regulatory requirements related to managed care plans and accreditation standards Maintain detailed records of credentialing activities, updates, and correspondence for audit purposes Collaborate with internal teams to resolve credentialing discrepancies or issues efficiently Qualifications Prior experience in medical office administration or healthcare credentialing is highly preferred Strong knowledge of managed care processes and NCQA standards is essential Familiarity with medical terminology and healthcare documentation practices Excellent organizational skills with keen attention to detail and accuracy Ability to manage multiple tasks simultaneously while meeting deadlines Effective communication skills for liaising with providers, licensing agencies, and insurance companies Proficiency in using credentialing software or healthcare management systems is a plus Join us in a role that combines precision with purpose! As a Credentialing Specialist, you'll play a crucial part in supporting our mission to deliver exceptional healthcare services. We're committed to fostering an inclusive environment where your skills can thrive while making a meaningful impact on patient care quality.

Pay:

From $22.00 per hour

Benefits:

Paid time off

Experience:

e

ClinicalWorks:

1 year (Preferred)

Work Location:

Hybrid remote in Phoenix, AZ 85017