Credentialing Specialist

2 hours ago


Baltimore, Maryland, United States nTech Workforce Full time
Job Title: Credentialing Specialist

We are seeking a highly skilled Credentialing Specialist to join our team at nTech Workforce. As a Credentialing Specialist, you will play a critical role in supporting the credentialing of new practitioners for network participation within our organization's Behavioral Health Network.

Key Responsibilities:
  • Verify provider eligibility and maintain accurate provider data within the enterprise-wide Provider file.
  • Manage and reconcile data in Excel, ensuring the accuracy and efficiency of the credentialing process.
  • Respond to external and internal inquiries regarding provider participation eligibility and criteria.
  • Maintain the provider file, including updates to provider information during processes such as credentialing, recredentialing, and terminations.
  • Identify and resolve provider file issues, processing inputs in accordance with applicable state laws and departmental guidelines.
Requirements:
  • 2+ years of credentialing experience in the healthcare/health insurance industry.
  • Experience with primary sourcing of credentials, including licenses and work experiences.
  • Proficiency in Microsoft Excel, including Pivot Tables and VLOOKUPs.
  • Strong customer service skills and excellent written and verbal communication skills.
  • Highly organized and detail-oriented, with the ability to quickly learn new systems and navigate multiple portals simultaneously.
Preferred Qualifications:
  • Experience using MD-STAFF or similar provider credentialing databases.


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