Credentialing Specialist

19 hours ago


Highlands Ranch, Colorado, United States OnPoint Medical Group Full time
Job Title: Credentialing Specialist

We are seeking a highly organized and meticulous Credentialing Specialist to join our team at OnPoint Medical Group. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and completeness of provider credentialing information.

Key Responsibilities:
  • Process initial credentialing and re-credentialing applications for healthcare providers
  • Screen practitioners' applications and supporting documentation to verify eligibility
  • Identify discrepancies in information and conduct follow-up investigations
  • Maintain internal and external databases, including CAQH, PECOS, and NPPES
  • Assist customers with credentialing inquiries and respond to health plan providers' inquiries
  • Perform audits of health plan directories and ensure accurate provider information
  • Manage CAQH creation and maintenance, Medicare and Medicaid enrollment, and revalidation
  • Perform provider roster reconciliation and initial and reappointment of hospital privileges
Requirements:
  • High school diploma or GED required; Bachelor's degree preferred
  • 3+ years of credentialing experience
  • Certified Provider Credentials Specialist (CPCS) certification preferred
  • Knowledge of Medicare and Medicaid enrollment and revalidation procedures
  • Excellent verbal and written communication skills
  • Proficient in Microsoft Office Word and Excel, with experience in Vlookup
  • Ability to work independently and as part of a team
Benefits:
  • Competitive hourly wage: $20-$27
  • Health insurance plan options for you and your dependents
  • Dental and vision insurance for you and your qualified dependents
  • Company-paid life insurance
  • Voluntary options for short-term disability and long-term disability coverage
  • AFLAC plans
  • FSA options
  • Eligible for 401(k) after 6 months of employment with a 4% match that vests immediately
  • Paid time-off earned

OnPoint Medical Group is an EEO Employer.



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