Credentialing Specialist

3 weeks ago


Sedalia, United States OnPoint Medical Group Full time
Job Title: Credentialing Specialist

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 re-credentialing applications for healthcare providers
  • Screen practitioners' applications and supporting documentation to verify eligibility
  • Maintain internal and external databases, including CAQH, PECOS, and NPPES
  • Assist customers with credentialing inquiries and respond to health plan providers' inquiries
  • Perform audits of health plan directories and ensure accurate provider information
  • Manage CAQH creation and maintenance, Medicare and Medicaid enrollment, and revalidation
  • Perform provider roster reconciliation and initial and reappointment of hospital privileges
Requirements:
  • High school diploma or GED required; Bachelor's degree preferred
  • 3+ years of credentialing experience
  • Certified Provider Credentials Specialist (CPCS) certification preferred
  • Knowledge of Medicare and Medicaid enrollment and revalidation procedures
  • Excellent verbal and written communication skills
  • Proficient in Microsoft Office Word and Excel
Work Environment:

The Credentialing Specialist will work in the corporate office in Highlands Ranch, CO. This is not a remote position.

Benefits:
  • Health insurance plan options for you and your dependents
  • Dental and vision insurance 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

Salary: $20 - $27 per hour

The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have, and comparison to other employees already in this role.

OnPoint Medical Group is an EEO Employer.



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