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Credentialing Specialist in Healthcare
2 months ago
Position Overview:
We are currently seeking a dedicated Physician Credentialing Specialist to join our team in a hybrid work environment. This role is essential in supporting our organization in the credentialing process for a significant number of healthcare providers.
Job Responsibilities:
- Manage the complete credentialing process for physicians across various health plans, including Medicaid, Medicare, and commercial insurance providers.
- Collaborate with health insurance organizations to ensure accurate reporting of credentialing data.
Qualifications:
- A minimum of an Associate's degree is required.
- At least three years of experience in physician credentialing is essential.
- Familiarity with credentialing software, particularly CAQH ProView, is preferred.
- Understanding of the submission process for credentialing information to health plans and payers.
- Knowledge of the healthcare sector, including regulations from NCQA, MSO, CMS, and federal guidelines.
- Proficient in Microsoft Office Suite, including Excel, Word, Access, PowerPoint, and Outlook.
If you are qualified and interested in this opportunity, we encourage you to submit your resume for consideration.
