Credentialing Specialist

Think Big Health Care Solutions is practice management and consulting firm based in South Florida seeking an experienced credentialing specialist to join our growing credentialing team. Our ideal candidate is detail oriented, has strong computer skills, reasoning skills, excels at excellent customer service and is a team player.

Please only apply if you have prior provider enrollment experience

Duties and Responsibilities:

• Performs all aspects of credentialing activities to ensure effective operations, compliance with government/state regulations, and that all providers are appropriately credentialed
• Accurately and timely completes all applications providing accompanying documents for credentialing and re-credentialing of practitioners
• Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
• Processes requests for privileges accurately
• Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
• Monitors the initial, reappointment and the expirable process for all providers, ensuring compliance with regulatory bodies
• Performs miscellaneous job-related duties as assigned.
• Handles the review and analysis of provider applications and accompanying documents, ensuring applicant eligibility.
• Prepares credentials file for completion and presentation to Credentialing manager
• Performs miscellaneous job-related duties as assigned.
• Manage credentialing activities by gathering appropriate provider data, review due diligence documents and document all credentialing in appropriate files/records
• Manage assignments, work flow and establishes priorities on a daily basis
• Able to assist with contract acquisition and follow-up
• Escalate issues to the appropriate members of the credentialing team, and/or co-workers as necessary to problem solve matters through clear communications.
• Ensure proper follow up is completed ahead of deadlines