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Provider Credentialing Specialist

2 months ago

Miami, United States Alivi Full time

POSITION OVERVIEW
The Credentialing Operations Coordinator is tasked with essential administrative functions pertaining to the credentialing of healthcare providers. This role is pivotal in gathering necessary documentation for both initial and ongoing credentialing processes. The Coordinator diligently monitors and reports on credential expiration dates to ensure that all records are current and accurately maintained. Furthermore, this position is crucial in facilitating a seamless credentialing workflow and ensuring that all documentation is properly archived within the credentialing management system.

KEY RESPONSIBILITIES

  • Engage with providers through various communication channels to collect required documentation.
  • Oversee the maintenance of credentialing databases, ensuring accurate updates, removals, and additions of provider information.
  • Adhere to internal credentialing protocols for the completion of applications related to providers, vehicles, and facilities.
  • Conduct thorough reviews of credentialing documents to guarantee a comprehensive and organized file for primary source verification.


  • Collaborate with relevant departments regarding any changes, denials, or issues related to applications.

  • Distribute introductory email packages to providers.
  • Utilize Microsoft Office Suite (Outlook, Excel, PowerPoint, Word) for various tasks.
  • Accurately input data received from providers into the credentialing database.
  • Proactively monitor credential expiration dates and communicate with providers as necessary.


  • Maintain the integrity of provider contracting and credentialing documentation.

QUALIFICATIONS & SKILLS

  • High school diploma or equivalent required.
  • A minimum of 3 years of relevant experience or training.
  • Proficient computer skills are essential.
  • Exceptional attention to detail is required.
  • Strong written, verbal, and interpersonal communication skills, with an emphasis on active listening and clear information dissemination.


  • Proven ability to build relationships and collaborate effectively with colleagues and clients.
  • Exhibit a positive demeanor and maintain a solution-oriented, customer-centric approach.
  • Ability to thrive in a fast-paced environment.
  • Professional demeanor in both in-person and telephonic interactions.
  • Bilingual proficiency in English and Spanish is preferred.