Medical Credentialer

Seeking an efficient, experienced credentialer to manage insurance and hospital credentialing for busy multi-speciality physician practice and out-patient surgery center.

Credentialer Job Responsibilities:

• Completes applications and reappointments for in a timely manner, ensuring continuous privileges.
• Maintains CAQH, ensuring accurate information and timely re-attestations.
• Track license, certification, and medical expirations to ensure timely renewals.
• Maintains copies of current state licenses, certifications, and medical testing results.
• Ensures compliance with company standards, and client requirements, State and Federal policies and regulations
• Keeps team members updated, especially with newly onboarded providers or newly requested facilities.
• Maintains rapport with insurance and hospital staff, facilitating communication and resolution of issues.

Qualifications

Credentialer Education and Experience Jobs Requirements:

• Minimum: Associate's Degree in related field. Education may be substituted for related experience.
• Ability to communicate effectively;
• Ability to work independently;
• Skilled in a variety of software applications such as Excel, Word, and Outlook programs.
• Some medical knowledge or medical group practice knowledge helpful.
• Two (2) years of related experience