Credentialing Specialist
3 weeks ago
We are seeking a highly skilled Credentialing Specialist to join our team at MyCare Medical Group. The successful candidate will be responsible for ensuring that all medical providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities.
Key Responsibilities- Process initial credentialing and re-credentialing applications for medical providers
- Screen practitioners' applications and supporting documentation to ascertain their eligibility
- Identify discrepancies in information and conduct follow-ups to ensure accurate and up-to-date data
- Maintain internal and external databases, including CAQH, PECOS, and NPPES
- Assist patients and health plan providers with inquiries and resolve issues in a timely manner
- Perform audits of health plan directories and ensure accurate provider information
- Coordinate with health plans to ensure timely renewal of licenses and certifications
- Collaborate with internal teams to resolve health plan issues and maintain provider data
- High school diploma or equivalent required
- 1+ years of experience in healthcare credentialing and registration
- Knowledge of Managed Care Organizations (MCOs) and Centers for Medicare & Medicaid Services (CMS) credentialing and registration requirements
- Excellent communication and interpersonal skills
- Ability to work in a fast-paced environment and prioritize multiple tasks
- Comprehensive benefits package, including health, vision, dental, and life insurance
- 401(k) retirement plan and PTO accrual
- Opportunities for professional growth and development
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Credentialing Specialist
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Lutz, United States MyCare Medical Group Full timeOVERVIEW OF POSITION:This position is not remote. We are looking for individuals who live within a commutable distance from our Central Business Office, located in Lutz, FL. The Credentialing Specialist will be responsible for all aspects of the credentialing, recredentialing and privileging processes for all medical providers who provide patient care,...
