Credentialing Specialist

21 hours ago


Kansas City, Missouri, United States Swope Health Services Full time
About the Role

Swope Health Services is seeking a highly skilled Credentialing Specialist to join our team. As a key member of our healthcare team, you will play a critical role in ensuring the highest quality provider network for our patients.

Key Responsibilities
  • Develop and implement centralized credentialing and privileging processes and procedures for Swope practitioners.
  • Prepare credentialing and privileging documents for initial appointments and reappointments in a timely and complete manner.
  • Work closely with physicians, mid-levels, and other licensed practitioners to acquire necessary materials and information for enrollment with commercial insurance plans.
  • Ensure compliance with HRSA, JCAHO, and other grant makers or certification standards for credentialing and privileging of various practitioner types.
  • Coordinate with various departments to ensure communication of completed credentialing and privileging requirements to ensure appropriate billing for services.
  • Convene monthly Credentialing Committee meetings, prepare agendas, and record decisions.
Requirements
  • Associate degree in business administration or equivalent experience, bachelor's degree preferred.
  • 1-5 years credentialing experience or relevant work experience required.
  • Certified Provider Credentialing Specialist certification preferred.
About Swope Health Services

Swope Health Services is a special place that cares for the people who need it most. We deliver coordinated care that values the needs of the whole person and champion better health in our community. Our team members are proud of the work we do and the promise we've made.

We support our team members with medical benefits, 401(k) retirement plan, company-paid benefits, flexible spending account, paid days off, and eight annual company-paid holidays.

Swope Health is an affirmative-action, equal-opportunity employer. We consider all qualified applicants without regard to race, color, creed, religion, gender, national origin, age, marital status, veteran status, or disability.



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