Managed Care Credentialing Specialist

6 days ago


St Louis, Missouri, United States Burrell Behavioral Health Full time
Job Summary

Burrell Behavioral Health is seeking a highly skilled Managed Care Credentialing Representative II to join our team. As a key member of our credentialing team, you will be responsible for ensuring the smooth onboarding process of healthcare providers, ensuring compliance with regulatory standards, and maintaining accurate and up-to-date provider data.

Key Responsibilities
  • Meet with providers to complete credentialing applications and ensure timely completion of all required documents and tasks.
  • Compile and maintain accurate and current provider data in our credentialing database and files.
  • Complete and monitor provider credentialing and re-credentialing applications, following up in a timely manner to ensure compliance with regulatory standards.
  • Investigate and document practitioner credentials, utilizing specialized knowledge to obtain verification of all aspects of a practitioner's background, training, and past practice.
  • Notify supervisors and management of adverse or questionable responses from the verification process.
  • Assist providers with changes in privileges or license type.
  • Maintain department standards while meeting all required regulations.
Requirements
  • High school diploma, GED, or equivalent required.
  • Healthcare credentialing experience required.
  • Experience in healthcare administration utilizing advanced Microsoft Office and Excel preferred.
What We Offer

Burrell Behavioral Health offers a competitive salary and benefits package, as well as opportunities for professional growth and development.



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