Credentialing Specialist
2 weeks ago
Epitec
POSITION:
Credentialing Specialist
JOB TYPE:
Contract, W2, Full-time
LOCATION:
Chicago, IL
JOB SUMMARY FOR CREDENTIALING SPECIALIST:
- This position is responsible for analyzing, researching, and applying business rules to complete requests from providers regarding adds, deletes, and changes to their information used for claims processing, membership assignment, and directory purposes. The role involves contracting, credentialing, and maintaining Facility/Professional provider data to support marketing and network contracting across all lines of business. Additionally, the position supports the implementation of special projects, assists with tracking various project phases, and manages workflow. The role also includes assisting management in training team members on business rules in network contracting and credentialing, identifying gaps in processes, and suggesting process improvement strategies.
REQUIRED EXPERIENCE FOR CREDENTIALING SPECIALIST:
- Bachelor’s degree plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.
SKILLS AND QUALIFICATIONS FOR CREDENTIALING SPECIALIST:
- Strong written and verbal communication skills, including interpersonal skills.
- Ability to develop training materials and act as an advisor to staff.
- Proficiency in Microsoft Office software products, including analytical tools. Experience in developing reports.
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