Credentialing Specialist

6 days ago


Marquand, Missouri, United States JWM Neurology Full time
Job Title: Credentialing Specialist

Job Summary:

We are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at JWM Neurology PC. The successful candidate will be responsible for managing all credentialing activities related to privileges for our providers.

Key Responsibilities:

* Maintain the One_App database with accurate and up-to-date provider information
* Complete hospital and insurance/payer applications for new providers
* Update applications with hospitals and insurance/payers as necessary
* Manage the CAQH database for providers
* Ensure compliance with state licenses, state CDR, and DEA requirements
* Update insurance company location and provider listings as needed
* Maintain Medicare 855 forms
* Collaborate with the Business Office to resolve insurance credentialing issues

Requirements:

* Minimum of two years of experience in healthcare-related credentialing and insurance/billing
* Strong knowledge of credentialing database software and medical terminology
* Excellent communication and problem-solving skills

Working Conditions:

This role requires frequent mobility and/or sitting for extended periods. Manual dexterity is necessary for using a calculator and computer keyboard. Some bending and stooping may be required. Work is performed in a busy office environment with frequent contact with employees and outside agencies.

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