Credentialing Specialist

Job DescriptionJob DescriptionPosition Description: About Peak ENT Associates:
Peak ENT Associates is a premier provider of comprehensive ear, nose, and throat (ENT) healthcare services. Our mission is to deliver exceptional patient care through innovative treatments and personalized service. We are seeking a detail-oriented and organized individual to join our team as a Credentialing Specialist.
Job Overview:
The Credentialing Specialist is responsible for managing all aspects of the credentialing process for providers, payers, and facilities. This role involves ensuring that all healthcare providers meet the necessary qualifications and are compliant with state, federal, and organizational standards. The ideal candidate will have a thorough understanding of credentialing processes, excellent organizational skills, and the ability to manage multiple tasks efficiently.
Key Responsibilities:
Manage the entire credentialing process for healthcare providers, including initial credentialing, re-credentialing, and ongoing monitoring.
Prepare and submit credentialing applications to insurance payers and healthcare facilities.
Verify provider qualifications, including education, training, certifications, and work experience.
Ensure timely and accurate completion of credentialing and re-credentialing applications.
Maintain and update credentialing records and databases, ensuring all information is current and accurate.
Communicate with providers, payers, and facilities to resolve any issues or discrepancies during the credentialing process.
Monitor and track the status of credentialing applications and follow up as necessary to expedite approvals.
Ensure compliance with all regulatory and accreditation standards, including those set by The Joint Commission, NCQA, and CMS.
Assist in developing and implementing policies and procedures related to credentialing and privileging.
Provide support during audits and inspections, ensuring all credentialing documentation is complete and accessible.
Stay updated on industry trends, regulatory changes, and best practices in credentialing.
Qualifications:
Bachelors degree in Healthcare Administration, Business Administration, or a related field preferred.
Proven experience in healthcare credentialing, preferably in an ENT or specialty practice.
Strong knowledge of credentialing standards and regulatory requirements.
Proficiency in credentialing software and databases.
Excellent organizational and time management skills.
Strong attention to detail and accuracy.
Excellent communication and interpersonal skills.
Ability to handle sensitive information with discretion and maintain confidentiality.
Preferred Skills:
Certification in healthcare credentialing (e.g., CPCS, CPMSM).
Experience with payer enrollment processes and requirements.
Familiarity with electronic health records (EHR) systems.
What We Offer:
Competitive salary and benefits package.
Opportunities for professional development and career growth.
A collaborative and supportive work environment.
The chance to make a meaningful impact on patient care and provider satisfaction.
How to Apply:
Interested candidates should submit their resume and cover letter to admin@peakent.com with the subject line "Credentialing Specialist Application - [Your Name]." Applications will be reviewed on a rolling basis until the position is filled.
Peak ENT Associates is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Join our team and contribute to the excellence in ENT healthcare at Peak ENT Associates

$22.00 - $28.00 Hourly

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