Certification Manager

4 days ago


Frisco, Texas, United States Careington International Corp Full time
Careington International Corporation is a leading provider of discount healthcare solutions. With a rich history dating back to 1979, our mission remains unchanged: to create innovative healthcare programs that benefit employers, providers, and members alike.

This full-time, hybrid position involves managing the credentialing and re-credentialing process for healthcare providers, ensuring compliance with relevant regulations and Careington standards. As a Credentialing Specialist, you will be responsible for verifying credentials, including licensure, certifications, and malpractice insurance, to ensure providers meet the required qualifications. This role plays a critical part in maintaining high-quality care within Careington's networks.

The ideal candidate will possess excellent attention to detail, strong communication skills, and the ability to manage multiple tasks simultaneously. Proficiency in Microsoft Office Suite is also essential. If you are a motivated and organized individual looking for a challenging role, we encourage you to apply.

Key Responsibilities:
  • Credentialing & Re-Credentialing:
    • Collect and verify provider credentials, including licensure, certifications, and malpractice insurance.
    • Manage timely and accurate completion of initial credentialing and re-credentialing applications.
    • Ensure all documentation meets legal and Careington requirements.
  • Primary Source Verification:
    • Conduct primary source verification (PSV) for provider credentials, including licensure, board certifications, and malpractice claims.
  • Provider Data Management:
    • Maintain accurate provider records and databases, updating information regularly as per credentialing requirements.
  • Communication:
    • Serve as a point of contact for providers regarding credentialing status and document requests.
  • Problem Resolution:
    • Address and resolve discrepancies or issues related to provider credentials, ensuring timely solutions.

Estimated Salary: $60,000 - $80,000 per annum, depending on experience.
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