Credentialing Specialist

Job Summary

To support a growing healthcare practice, the full-time Credentialing and Provider Enrollment Specialist will compile, maintain, and verify provider data and profiles while efficiently completing provider enrollment and re-credentialing applications remotely.

Key responsibilities

• Compile, maintain, and verify provider data and profiles for various insurance plans
• Accurately complete provider enrollment and re-credentialing applications while monitoring expiring licenses and certifications
• Professionally communicate with providers and liaisons to gather necessary information and resolve enrollment issues

Required qualifications

• 2 years of administrative experience in a healthcare setting
• 2 years of credentialing and re-credentialing experience
• Strong knowledge of CAQH, AMA, DEA, CMS, PECOS, OIG, ABMS, AOA, and NCQA regulations
• Proficiency in Microsoft Office and experience with Symplr and Intellicred software
• Ability to work independently in a fast-paced environment with competing deadlines