Senior Credentialing Specialist

4 days ago


Baton Rouge, Louisiana, United States Premier Health Full time
Job Summary

We are seeking a highly skilled Credentialing and Recredentialing Professional to join our team at Premier Health. As a key member of our healthcare team, you will be responsible for ensuring the accuracy and completeness of medical provider credentialing and recredentialing processes.

Key Responsibilities
  • Process initial credentialing and recredentialing applications for medical providers
  • Screen and verify practitioner applications and supporting documentation
  • Collect and analyze information from various sources, including the National Practitioner Data Bank (NPDB)
  • Identify and resolve discrepancies in provider information
  • Present applications to the Credentialing Committee for review and approval
  • Assist with credentialing inquiries and respond to health plan provider inquiries
  • Capture and maintain primary source documentation in computer databases
  • Ensure data integrity and compliance with applicable laws and regulations
Requirements
  • High School Graduate or specialized training combined with 3+ years of experience in office operations
  • Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations
  • Ability to write reports, business correspondence, and procedure manuals
  • Strong communication and interpersonal skills
  • Ability to work in a fast-paced environment and prioritize multiple tasks
Working Conditions

The work environment is typically quiet to moderate, with occasional exposure to infectious or contagious diseases and electromechanical hazards.



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