Credentialing Specialist
1 week ago
We are seeking a highly organized and detail-oriented 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.
Responsibilities:- Process initial credentialing and re-credentialing applications
- Screen practitioners' applications and supporting documentation to ascertain their eligibility
- Identify discrepancies in information and conduct follow-ups
- Maintain internal and external databases (CAQH, PECOS, NPPES)
- Assist customers with credentialing inquiries
- Respond to health plan providers' inquiries
- Responsible for follow-up after submission to ensure that health plans appropriately processed the request and that provider information shows correctly on the health plans website
- Audit Health Plan Directory
- CAQH creation and maintenance experience
- Medicare & Medicaid enrollment and revalidation
- Perform provider roster reconciliation
- Initial and reappointment of hospital privileges
- High school diploma or GED required (Bachelors Degree preferred)
- 3+ years credentialing experience
- Certified Provider Credentials Specialist (CPCS) preferred
- Knowledge of Medicare & Medicaid enrollment and revalidation
- Knowledge of medical credentialing and privileging procedures and standards
- Excellent verbal and written communication skills
- Proficient with Microsoft Office Word & Excel (Vlookup)
- Demonstrate skills in problem solving analysis and resolution
- Attention to detail
- Must be able to function independently and as a team
- Demonstrate flexibility in multiple project manager and strict deadlines
- Health insurance plan options for you and your dependents
- Dental, and Vision, 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
Salary: $20 - $27 / hour
The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role.
OnPoint Medical Group is an EEO Employer.
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