Credentialing Operations Specialist

2 weeks ago


Baltimore, Maryland, United States nTech Solutions, Inc. Full time

Terms of Employment

  • Contract, 6 Months (Potential for Extension / Possible Conversion)
  • This position is primarily remote, with the expectation that candidates reside within a reasonable commuting distance to Baltimore, MD for occasional onsite engagements.

Overview
nTech Solutions, Inc. is seeking a dedicated Credentialing Specialist to assist in the verification and credentialing of new practitioners for participation in our Behavioral Health Network. The role requires ensuring that providers meet the necessary qualifications for program participation while meticulously maintaining all provider data in accordance with industry standards.

Key Responsibilities

  • Manage provider applications from initiation to completion, performing twelve (12) primary source verifications within the credentialing file. Upon completion, data will be entered into the EVIP system, followed by the preparation of a spreadsheet for downstream systems integration.
  • Address inquiries from both external and internal stakeholders regarding provider eligibility, credentialing status, and updates to provider files, ensuring a focus on provider experience and timely resolutions.
  • Maintain the integrity of the provider file, including electronic records, during processes such as credentialing, recredentialing, and demographic updates.
  • Identify and resolve existing issues within provider files, ensuring compliance with applicable state laws and departmental guidelines.
  • Draft written communications to obtain missing information and effectively communicate via telephone as necessary.


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