Job Description
Job Overview Join our dynamic healthcare team as an Insurance Credentialing Specialist, where your expertise will be pivotal in ensuring seamless provider enrollment and credentialing processes. In this energetic role, you will manage the accreditation and verification of healthcare providers’ credentials, ensuring compliance with industry standards and payer requirements. Your proactive approach will help maintain strong relationships with insurance payers and support the delivery of high-quality patient care. If you thrive in a fast-paced environment and are passionate about accuracy and compliance, this position offers an exciting opportunity to make a meaningful impact in healthcare administration. Duties Coordinate and complete provider credentialing applications with insurance payers, ensuring all documentation aligns with regulatory standards. Maintain up-to-date records of provider credentials, licenses, certifications, and other necessary documentation. Verify provider information against NCQA (National Committee for Quality Assurance) standards to ensure compliance and accreditation readiness. Track credentialing deadlines and renewal dates to prevent lapses in provider enrollment status. Collaborate with medical offices to gather required documentation and resolve any discrepancies or issues promptly. Communicate effectively with insurance companies, providers, and internal teams to facilitate smooth credentialing workflows. Support ongoing compliance initiatives related to managed care contracts and industry regulations. Requirements Proven experience in managed care or healthcare administration, preferably within a medical office setting. Strong knowledge of medical terminology to accurately interpret provider credentials and documentation. Familiarity with NCQA standards and accreditation processes to ensure compliance across all credentialing activities. Excellent organizational skills with the ability to manage multiple deadlines simultaneously. Effective communication skills for liaising with providers, payers, and internal staff. Attention to detail to ensure accuracy in all credentialing documentation and records. Ability to adapt quickly in a fast-paced environment while maintaining high standards of quality. Join us as an Insurance Credentialing Specialist and become a vital part of our mission to support healthcare providers in delivering exceptional patient care through efficient credentialing processes! Pay: $24.70 - $29.75 per hour Work Location: In person