Credentialing Specialist
1 week ago
- Maintain accurate and up-to-date provider databases to ensure compliance with regulatory requirements.
- Process initial and reappointment credentialing applications, verifying healthcare provider information and licensing.
- Coordinate with medical staff personnel to ensure contract providers and allied health professionals are properly licensed and credentialed.
- Track provider certifications, licensure expiration dates, and other expirable documentation to ensure ongoing compliance with regulatory standards.
- Establish and maintain data entry in Credentialing for Affordable Quality Healthcare (CAQH).
- Maintain good rapport and professional communication with Health Plan Representatives.
- Support provider enrollment staff with Medicare, Medicaid, and commercial insurances for Maryland.
- Communicate with healthcare providers and external agencies regarding licensing and credentialing requirements.
- High school diploma or equivalent required.
- Experience with state, federal, and accreditation entity regulations and requirements related to credentialing and privileges.
- Certification in Medical Staff Services (CMSS) or Certified Provider Credentialing Specialist (CPCS) preferred.
- Current knowledge of provider enrollment processes with Medicare, Medicaid, and commercial insurances.
- Minimum of 3 years' experience in credentialing and provider enrollment at a healthcare facility; experience in a Federally Qualified Health Center preferred.
- Ability to prioritize tasks and work independently.
- Excellent verbal and written communication skills.
- Strong organizational and analytical skills, with attention to detail.
- Extensive benefits plan.
- Generous PTO Plan.
- 403B Retirement Plan + Employer match up to 4%.
- Tuition Reimbursement.
- Continuing education assistance; can be used toward obtaining certifications, renewal of certifications, or possible conference attendance.
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Silver Spring, Maryland, United States Community Clinic Full time{"Job Title": "Credentialing Coordinator", "Job Summary": "We are seeking a highly organized and detail-oriented Credentialing Coordinator to join our team at Community Clinic. In this role, you will be responsible for credentialing new and established healthcare providers, maintaining provider databases, and ensuring compliance with regulatory guidelines.",...
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