Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist to support a team of clinicians in delivering complex health services.

Key Responsibilities

• Maintain high quality, timely, and accurate credentialing processes for healthcare professionals
• Lead the credentialing process by collecting information and completing applications for payers and hospitals
• Act as a liaison between providers and payers, managing credentialing and re-credentialing information

Required Qualifications

• 5-7+ years of direct healthcare credentialing/privileging experience on a multi-state, multi-entity scale
• 2+ years of experience with credentialing software implementation and utilization
• Demonstrated knowledge of managed care, Medicare reimbursement methodologies, and legislative regulations
• Proficiency in Microsoft Office (Excel, Word, Outlook)
• Strong understanding of HIPAA privacy requirements