Healthcare Credentialing Specialist

3 weeks ago


Arlington, Virginia, United States The GW Medical Faculty Associates Full time
About the Role
The GW Medical Faculty Associates seeks a skilled Healthcare Credentialing Specialist to join our team. This is an exciting opportunity to work in a fast-paced environment where you will be responsible for performing day-to-day credentialing and re-credentialing activities for providers within the Credentialing Department. You will work closely with MFA departmental contacts to ensure a smooth and efficient credentialing process.

Key Responsibilities
This role involves conducting and participating in credentialing and privileging activities, utilizing the CAQH database to retrieve and analyze practitioner applications, ensuring compliance with accreditation and regulatory standards, and completing practitioners' enrollment applications into various governmental payors. Additionally, you will perform primary source verification activities, obtain and evaluate information from acceptable primary sources, and identify, investigate, and report any discrepancies or adverse information obtained from practitioner applications or primary source verifications.

Requirements
To be successful in this role, you will require a high school diploma or higher, or an equivalent combination of training and experience. A minimum of 2 years of experience credentialing in a large healthcare system is also required. Prior experience in managed care and credentialing environments is strongly preferred. Strong knowledge of NCQA credentialing standards and regulatory requirements is essential. Professional experience using Microsoft Office applications, including Excel and Word, is also necessary. We strongly prefer candidates who hold a Certified Provider Credentialing Specialist (CPCS) certification.

What We Offer
We offer a competitive salary of $65,000 - $80,000 per year, depending on experience. In addition, we provide a comprehensive benefits package, including medical, dental, and vision insurance, as well as a generous retirement plan. Our team members enjoy a dynamic and supportive work environment, with opportunities for professional growth and development.

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