Current jobs related to Provider Credentialing Specialist - Phoenix, Arizona - Blue Cross Blue Shield of Arizona
-
Provider Credentialing Specialist
4 weeks ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeJob Title: Provider Credentialing SpecialistWe are seeking a highly skilled Provider Credentialing Specialist to join our team at LHH Recruitment Solutions. As a key member of our healthcare team, you will be responsible for ensuring the timely and accurate credentialing of healthcare providers.Responsibilities:Monitor and manage the credentialing process...
-
Provider Credentialing Specialist
1 month ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeJob Title: Provider Credentialing SpecialistWe are seeking a highly skilled Provider Credentialing Specialist to join our team at LHH Recruitment Solutions. As a key member of our team, you will be responsible for ensuring the timely completion of provider credentialing and re-credentialing processes.Key Responsibilities:Verify provider qualifications,...
-
Provider Credentialing Specialist
3 weeks ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeJob Title: Provider Credentialing SpecialistLead Provider Credentialing/Enrollment SpecialistMinimum 5 years of experience in recent Provider Enrollment/CredentialingONSITE: Phoenix, AZ 85008Pay range: $21 - $25 per hour (position bonus eligible)Full-time | 7a – 4pKey Responsibilities:Monitor provider credentialing and re-credentialing, ensuring timely...
-
Provider Credentialing Specialist
1 month ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeJob Title: Provider Credentialing SpecialistLead Provider Credentialing/Enrollment SpecialistKey Responsibilities:Monitor provider credentialing and re-credentialing, ensuring timely completion of required documents.Verify provider qualifications, licenses, certifications, and educational background.Submit enrollment applications and monitor application...
-
Provider Credentialing Specialist
3 weeks ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeJob Title: Provider Credentialing SpecialistLead Provider Credentialing/Enrollment SpecialistMinimum 5 years of experience in recent Provider Enrollment/CredentialingONSITE: Phoenix, AZ 85008Pay Details: $21.00 to $25.00 per hourRole Responsibilities:Monitor provider credentialing and re-credentialing, ensuring timely completion of required documents.Verify...
-
Provider Credentialing Specialist
2 weeks ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeJob Title: Provider Credentialing SpecialistLead Provider Credentialing/Enrollment SpecialistMinimum 5 years of experience in recent Provider Enrollment/CredentialingKey Responsibilities:Monitor provider credentialing and re-credentialing, ensuring timely completion of required documents.Verify provider qualifications, licenses, certifications, and...
-
Provider Credentialing Specialist
4 weeks ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeLead Provider Credentialing/Enrollment SpecialistSeeking an experienced professional to oversee provider credentialing and enrollment processes. Minimum 5 years of experience in recent Provider Enrollment/Credentialing required.Key Responsibilities:Monitor provider credentialing and re-credentialing, ensuring timely completion of required documents.Verify...
-
Credentialing Specialist
3 weeks ago
Phoenix, Arizona, United States LHH Full timeCredentialing Specialist Job DescriptionLHH is seeking a skilled Credentialing Specialist to join our team in Phoenix, AZ. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and completeness of healthcare professional credentialing records.Key Responsibilities:Gather and verify primary source documentation for licenses,...
-
Credentialing Specialist
1 week ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeJob SummaryWe are seeking a highly skilled Credentialing Specialist to join our team at LHH Recruitment Solutions. As a Credentialing Specialist, you will play a pivotal role in coordinating and overseeing the credentialing and re-credentialing processes for practitioners.Key Responsibilities:Process credentialing applications and maintain the credentialing...
-
Credentialing Specialist
2 days ago
Phoenix, Arizona, United States LHH Recruitment Solutions Full timeAs a Credentialing Specialist, you will play a pivotal role in coordinating and overseeing the credentialing and re-credentialing processes for healthcare professionals. Responsibilities: Process credentialing applications and maintain the credentialing database according to internal policies and procedures. Ensure all credentialing processes comply with...
-
Credentialing Specialist
4 weeks ago
Phoenix, Arizona, United States Imsaz Full timeJob SummaryWe are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at IMS. As a Credentialing Specialist, you will be responsible for performing and maintaining timely, accurate, and complete third-party payor credentialing and hospital privileging for assigned IMS providers.Key ResponsibilitiesVerify provider status...
-
Credentialing Specialist
2 weeks ago
Phoenix, Arizona, United States Imsaz Full timeJob SummaryWe are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at IMS. As a Credentialing Specialist, you will be responsible for performing and maintaining timely, accurate, and complete third-party payor credentialing and hospital privileging for assigned IMS providers.Key ResponsibilitiesVerify provider status...
-
Credentialing Specialist
2 weeks ago
Phoenix, Arizona, United States LHH Full timeJob Title: Credentialing CoordinatorLocation: RemotePay Range: $24-29/hour (Based on Experience)LHH is seeking a skilled Credentialing Coordinator to join our team. This role involves gathering and verifying critical primary source documentation, ensuring compliance, and maintaining accurate credentialing records for healthcare...
-
Phoenix, Arizona, United States Southwest Division Full timeJob SummaryThe Southwest Division is seeking a highly skilled Division Contracts and Credentialing Specialist to lead the efforts in contract negotiations and analysis for Medicaid, managed care, and other ancillary/payor source contracts. This role requires a strong understanding of laws, regulations, and LCCA standards.Key ResponsibilitiesLead contract...
-
Healthcare Credentialing Specialist
1 week ago
Phoenix, Arizona, United States TEKsystems Full timeCredentialing Coordinator Job DescriptionThe Credentialing Coordinator is a critical role within our organization, responsible for ensuring the accuracy and compliance of credentialing documentation for various stakeholders. This position requires a high level of attention to detail and the ability to work effectively in a fast-paced environment.Key...
-
Credentialing Manager
3 weeks ago
Phoenix, Arizona, United States Beacon Talent Full timeJob OverviewWe are seeking a highly skilled Credentialing Manager to join our team at Beacon Talent. As a key member of our operations team, you will be responsible for overseeing the clinical onboarding and operations for our plans and providers.Key ResponsibilitiesDevelop and implement the overall clinical onboarding programEnsure seamless credentialing...
-
Regional Credentialing Coordinator
3 weeks ago
Phoenix, Arizona, United States United Surgical Partners International Inc (USPI) Full timeRegional Credentialing Coordinator OpportunityAn exciting opportunity is available for a highly motivated and detail-oriented Credentials Professional to join our team at United Surgical Partners International Inc (USPI). As a Regional Credentialing Coordinator, you will play a critical role in ensuring the accuracy and compliance of medical staff...
-
Division Contracts and Credentialing Manager
2 days ago
Phoenix, Arizona, United States Southwest Division Full timeJob Summary: We are seeking a highly skilled Division Contracts and Credentialing Specialist to lead our contract negotiation and analysis efforts for Medicaid, managed care, and other ancillary/payor source contracts. The ideal candidate will have a strong background in business or healthcare, with experience in contract negotiation and analysis.Key...
-
Healthcare Provider Enrollment Coordinator
2 weeks ago
Phoenix, Arizona, United States Altea Healthcare Full timeJob Summary:The Provider Enrollment Specialist plays a critical role in ensuring the smooth operation of our revenue cycle management department. This position is responsible for coordinating and managing the enrollment of healthcare providers into various insurance networks, including Medicare, Medicaid, and private insurance plans.Key...
-
Healthcare Provider Enrollment Coordinator
2 weeks ago
Phoenix, Arizona, United States Altea Healthcare Full timeJob SummaryThe Provider Enrollment Specialist plays a vital role in ensuring the smooth operation of healthcare provider enrollment and credentialing processes. This position is responsible for coordinating and managing the enrollment of healthcare providers into various insurance networks, including Medicare, Medicaid, and private insurance plans.Key...
Provider Credentialing Specialist
2 months ago
Recognized as a Healthiest Employer, Blue Cross Blue Shield of Arizona is dedicated to its mission of promoting health and simplifying healthcare access.
AZ Blue provides a comprehensive range of health insurance solutions tailored to meet the varied needs of individuals, families, and businesses of all sizes, while also offering resources to empower individuals in making informed health choices.
JOB PURPOSE
The Credentialing Coordinator is responsible for ensuring the precise and effective Credentialing and Recredentialing of providers within the Medicaid Business Segment, adhering to State, Federal, and NCQA standards.
ESSENTIAL QUALIFICATIONS
- Work Experience Requirements
- Minimum of 2 years in a healthcare environment
- Minimum of 2 years in provider credentialing
- Educational Requirements
- High School Diploma or GED in a relevant field
- Licensing Requirements
- N/A
- Certification Requirements
- N/A
- Preferred Work Experience
- 2 years in a healthcare setting, ideally in credentialing/recredentialing, with knowledge of national accreditation and regulatory standards
- Preferred Education
- Associate's Degree in a relevant field
- Preferred Licenses
- N/A
- Preferred Certifications
- Certified Provider Credentialing Specialist (CPCS)
- Ensure timely and accurate processing of credentialing and recredentialing for individual practitioners and organizations
- Organize Credentialing Committee meetings, including agenda preparation and documentation of minutes
- Identify and relay agenda items for the Credentialing Committee to the immediate supervisor
- Facilitate coordination with the Credentialing Verification Organization (CVO) and oversee the Work in Progress file
- Promptly address incoming files for processing
- Review and maintain all applications for accuracy and completeness
- Efficiently enter primary source verification data into the credentialing database
- Record credentialing decisions and dates in the credentialing database
- Generate and send approval letters to participating providers
- Identify and communicate any missing or incorrect information from provider applications
- Collaborate with Network Services and other internal departments on follow-up items necessary to complete the credentialing process
- Update Network Services and other internal departments regarding the status of provider and organizational credentialing
- Engage in ongoing cross-training activities
- Provide insights and suggestions for process enhancements and standardization practices
- Actively participate in team meetings, huddles, and one-on-one discussions
- Engage in team-building initiatives
- Perform additional duties as assigned
- This position requires a full-time commitment, defined as working at least 40 hours per week, with potential additional hours as needed to meet business demands
ESSENTIAL COMPETENCIES
- Job Skills
- Strong verbal and written communication abilities
- Maintains confidentiality in accordance with policy
- Effectively interacts with internal and external customers via phone and email
- Accurately processes information through oral communication
- Thoroughly reviews data and figures in both hard copy and electronic formats
- Efficiently analyzes data and resolves issues in a time-sensitive environment
- Quickly learns and retains new information and skills
- Effectively manages multiple tasks with varying priorities simultaneously
- Professional Competencies
- Critical thinking capabilities
- Strong attention to detail
- Excellent organizational skills
- Exceptional interpersonal skills, fostering trust with individuals at all levels
- Maintains composure while addressing concerns from internal and external customers
- Leadership Experience and Competencies
- N/A
- Preferred Job Skills
- Comprehensive understanding of managed care principles and physician practice operations, with knowledge of health plan credentialing preferred
- Preferred Professional Competencies
- N/A
- Preferred Leadership Experience and Competencies
- N/A
AZ Blue is committed to a diverse and inclusive workplace, ensuring equal opportunity in hiring and employment regardless of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other protected group.
