Credentialing Specialist

2 weeks ago


Scottsdale, Arizona, United States Palo Verde Cancer Specialists Full time
Job Summary

Palo Verde Cancer Specialists is seeking a skilled Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in ensuring the integrity of our provider data and maintaining compliance with regulatory requirements.

Key Responsibilities
  • Obtain and verify primary source information for all organizational facilities and entities
  • Maintain accurate and up-to-date records of provider credentials and licensure
  • Perform analysis and follow-up on credentialing applications and queries
  • Enter data into our database to ensure consistency and integrity
  • Process queries for expired licensure and regulatory credentialing requirements
  • Compile and maintain documentation in our database
  • Complete provider credentialing and recredentialing applications
  • Maintain knowledge of current health plan and agency requirements for credentialing providers
  • Track license, DEA, and professional liability expirations
  • Audit health plan directories for current and accurate provider information
Requirements
  • 3+ years of experience in credentialing and/or process management and operations
  • Strong knowledge of healthcare planning and medical terminology
  • Excellent communication and organizational skills
  • Ability to meet deadlines in a fast-paced environment
  • Experience with data entry, spreadsheets, and computer-related skills
Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.



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