Credentialing Specialist

4 weeks ago


Denver, Colorado, United States Alpine Physician Partners Full time
Job Summary:

Alpine Physician Partners is seeking a highly skilled Credentialing Specialist to join our team. As a Credentialing Specialist, you will be responsible for ensuring that all medical providers within our network are credentialed, enrolled, and privileged with health plans, hospitals, and patient care facilities.

Key Responsibilities:

Screen practitioners' applications and supporting documentation to ascertain their eligibility.
Identify discrepancies in information and conduct follow-ups.
Process initial credentialing and re-credentialing applications with follow-up to ensure that credentialing is completed, and providers are enrolled in health plan products.
Create and maintain internal and external databases, including CAQH, PECOS, and NPPES.
Assist internal customers with credentialing inquiries and actively participate in group leadership meetings.

Requirements:

High school diploma/GED required.
Completion of two or more years of college, preferred.
2+ years of experience working for a health maintenance organization, health plan, provider office, and/or in another health insurance-related setting.
Experience with Managed Care Organizations (MCO's) and Centers for Medicare & Medicaid Services (CMS) credentialing and registration requirements.

What We Offer:

Competitive hourly rate of $20-27.
Opportunity to work with a passionate team that believes in making a difference in the healthcare industry.
Collaborative work environment with opportunities for growth and development.

How to Apply:

If you are a motivated and detail-oriented individual with a passion for healthcare credentialing, please submit your application for consideration.

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