Credentialing, Privileging Specialist

2 weeks ago


Baltimore, Maryland, United States Healthcare For the Homeless Inc Full time
Job Summary

We are seeking a skilled Credentialing, Privileging Specialist to join our team at Healthcare for the Homeless Inc. The ideal candidate will have a strong focus on process and procedures, with the ability to work independently and problem-solve in a thoughtful and considered manner.

Key Responsibilities
  • Conduct comprehensive initial and ongoing credentialing and privileging of healthcare providers, maintaining up-to-date data and files for each provider in agency systems.
  • Coordinate provider enrollment processes with Medicare, Medicaid, and commercial payers, ensuring payer rosters are up to date with contracted providers.
  • Proactively engage with providers and departments to solicit, track, validate, and store documentation and information, including tracking license and certification expirations for all providers.
  • Create and maintain procedures and SOPs to ensure consistency of credentialing, privileging, and enrollment functions at the organization.
Requirements
  • Associate's degree required; Bachelor's degree preferred, preferably in HR, business, or a related field.
  • Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred.
  • Three years of administrative experience in a healthcare setting, with two years in provider credentialing and privileging.
What We Offer

At Healthcare for the Homeless Inc, we offer a collaborative and dynamic work environment, with opportunities for professional growth and development. We are an equal opportunity employer and are committed to racial equity and inclusion.



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