Credentialing Specialist
7 days ago
OnPoint Medical Group is seeking a highly organized and detail-oriented Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and completeness of provider credentialing information.
Key Responsibilities:- Process initial credentialing and recredentialing applications
- Screen practitioners' applications and supporting documentation to ascertain their eligibility
- Identify discrepancies in information and conduct follow-ups
- Maintain internal and external databases (CAQH, PECOS, NPPES)
- Assist customers with credentialing inquiries
- Respond to health plan providers' inquiries
- Responsible for follow-up after submission to ensure that health plans appropriately processed the request and that provider information shows correctly on the health plans website
- Audit Health Plan Directory
- CAQH creation and maintenance experience
- Medicare & Medicaid enrollment and revalidation
- Perform provider roster reconciliation
- Initial and reappointment of hospital privileges
- High school diploma or GED required (Bachelor's Degree preferred)
- Certified Provider Credentials Specialist (CPCS) preferred
- Knowledge of Medicare & Medicaid enrollment and revalidation
- Knowledge of medical credentialing and privileging procedures and standards
- Excellent verbal and written communication skills
- Proficient with Microsoft Office Word & Excel (Vlookup)
- Demonstrate skills in problem-solving analysis and resolution
- Attention to detail
- Must be able to function independently and as a team
- Demonstrate flexibility in multiple project management and strict deadlines
- Health insurance plan options for you and your dependents
- Dental, and Vision, for you and your qualified dependents
- Company Paid life insurance
- Voluntary options for short-term disability, and long-term disability coverage
- AFLAC Plans
- FSA options
- Eligible for 401(k) after 6 months of employment with a 4% match that vests immediately
- Paid Time-Off earned
OnPoint Medical Group is an EEO Employer.
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