Medical Credentialing Specialist

3 weeks ago


Columbia, United States Professional Management Enterprises Full time
Job DescriptionJob Description

Seeking a Credentialing Specialist to be responsible for the completion of the initial credentialing and re-credentialing process of providers to the network. MUST Reside in SC. Fully remote after onsite training in Columbia, SC. The schedule is M-F 8:00a-4:30p.

Job Essentials:

  • Maintains credentialing database and ensures provider databases are current and accurate.
  • Provides assistance to network staff, providers, contract services, marketing, and medical affairs.
  • Ensures compliance with external review organization standards and delegation agreements.
  • Performs initial and re-credentialing of providers/practitioners including documenting credentialing information.
  • Completes primary verification of state licensure, state/federal controlled substance certification, educational and/or residency background, malpractice coverage/history, hospital privileges, and previous sanctions.
  • Maintains credentialing database and HCS data files with appropriate network indicators and effective dates.


Required Education: Associate's Degree or Two years of related work experience Required Work Experience: 2 years’ experience in the healthcare or insurance industry.
 

Company DescriptionProfessional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.Company DescriptionProfessional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.

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