Credentialing Specialist

3 weeks ago

Bronx, New York, United States Essen Medical Associates Full time
Job Summary:

The Credentialing Specialist is responsible for coordinating and assisting with the day-to-day administrative functions of the Department. This role requires excellent written communication skills, the ability to multitask, and effective time management. The selected candidate will provide administrative support to the Delegation team within the Credentialing Department.

Key Responsibilities:
• Review credentialing applications for completeness and log any missing documentation
• Critically evaluate applications for any issues that may require special consideration or additional review, and take appropriate action to resolve the issue
• Perform primary source verification of credentials
• Notify the Supervisor and Associate Director of any red flags in a timely manner
• Coordinate with the appropriate credentialing onboarding staff to obtain required information from providers
• Prepare payment requests for required verification fees
• Participate in the timely preparation of files for the monthly Credentialing Committee meetings, Delegated Credentialing audits, on-site audits, and desktop audits
• Perform self-audits to ensure data integrity of provider files
• Implement proper maintenance of files (digital and hard copies)
• Complete other tasks or projects as assigned
• Provide backup to other Credentialing staff as necessary

Requirements:
Bachelor's Degree in a Health-Related Discipline: Public Health, Healthcare Administrative, Health Service, Psychology, or Sociology (Highly Preferred)
High School Diploma Required
Minimum of at least six months in a healthcare setting: providing clerical support or medical credentialing assistance. Preferably 1-2 years of relevant office/credentialing experience
Superior interpersonal skills to effectively interact with various levels of group practice leadership, as well as healthcare providers
Ability to communicate and process highly confidential information and exercise proper judgment and discretion in performing duties
Exceptional organizational, analytical, and written and verbal communication skills
Proficient with MS Office (Outlook, Word, Excel, PowerPoint, Access)
Excellent time-management skills
Knowledge of practitioner credentialing procedures and standards
Working knowledge of clinical operations and procedures
Informational research skills
$22.00-$25.00 an hour

Equal Opportunity Employer:

Essen Health Care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.

About Essen Health Care:

At Essen Health Care, we care for over 250,000 patients annually in New York City and beyond. Our commitment to innovating a better healthcare delivery system has fueled our growth from a single primary care office to an umbrella organization offering specialties from women's health to endocrinology, from psychiatry to a vast array of other specialties. We provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State.

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