Credentialing Specialist

2 weeks ago

Hillsboro, United States CampusPoint Full time
Credentialing Specialist Job Description

CampusPoint is seeking a skilled Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in ensuring the quality of practitioner credentialing and provider enrollment.

Key Responsibilities:

  • Compile and evaluate practitioner-specific data for review by the credentialing committee.
  • Analyze applications and support documents for accuracy and completeness.
  • Ensure timely verification of credentialing and re-credentialing applications.
  • Recognize and investigate discrepancies and adverse information obtained from applications or primary source verifications.
  • Maintain a credentialing database to ensure accurate and up-to-date data.
  • Assist in compliance with accrediting and regulatory agencies.
  • Coordinate and prepare reports about credentialing and payor enrollment processes.
  • Develop and update policies and procedures supporting organizational practices.
  • Manage forms and letters for new employee orientation, credentialing, and provider enrollment.
  • Participate in onboarding and orientation with education and follow-up on provider enrollment process.
  • Participate in audits of delegated credentialing entities.

Requirements:

  • Associate degree in Business Administration or a related field and three years of experience performing similar work.
  • Ability to communicate and analyze data and information.
  • Able to maintain confidentiality regarding credentialing matters.
  • Can display a credible presence and positive image.
  • Experienced in credentialing software, HRIS, EHR, Microsoft Office, and state and federal software programs.
  • Excellent written and verbal communication skills.
  • Professional demeanor.

CampusPoint is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.

If you need assistance or an accommodation due to a disability, you may contact us at or ask to speak with an HR representative. The process is outlined in CampusPoint's ADA Policy.

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