Credentialing Specialist

Hiring! Remote based Credentialing specialist with healthcare experience. This role will credential practitioners for network participation and accurately maintain all provider data within the enterprise-wide Provider file to supply the organization with provider data, while ensuring compliance with regulatory, accreditation, legal and company requirements and standards.

Licenses/Certifications
Certified Provider Credentialing Specialist (CPCS) Pref.

• 3 years physician credentialing experience or health insurance/managed care operations experience in a customer service, claims, billing and enrollment, or call center environment.
  Bachelor s Degree in Business, Healthcare Administration or related field
• Must be proficient in the use of Excel spreadsheets, and an understanding of Pivot tables., Proficient
• Excellent verbal and written communication and interpersonal skills. Ability to develop and maintain effective relationships with peers, physicians, and medical staff to create confidence, respect and dependability., Proficient
• Knowledge of medical terminology, Proficient
• Demonstrated proficiency utilizing reference materials and ability to follow Standard Operating procedures to reduce risk and ensure provider data accuracy and overall quality., Proficient
• Ability to understand jurisdictional requirements and the legal ramifications of the credentialing and provider file maintenance processes and interpret reasoning for performing verification and/or appropriate actions.