Credentialing Specialist Full Time

Job Summary :

Job Description

Essential Responsibilities:

• Assist in all aspects of new provider enrollment and onboarding.
• Serve as back-up to the Med Staff Coordinator and Senior Payor Enrollment Coordinator when needed.
• Participates in administrative duties as requested by department leadership including but not limited to committee/meeting preparations, special events and retreats.
• Ability to work in multiple systems for data management and tracking purposes.
• Maintain and exceed quantity and quality goals and standards set by the department.
• Additional responsibilities as assigned include assisting with committees and reporting.

Skills and Abilities:

• Knowledge of Government/ Medicare/ Regulatory Agency requirements relating to credentialing.
• Knowledge of federal/state licensures and certificates for health care entities or practitioners, e.g.: CLIA, DEA Certificates, CDS/Controlled Substance Licenses, BLS Certificates, etc.
• Knowledge of federal registers and retrieval of information
• Knowledge of the business documents required to complete the Ownership and Management Sections for Medicare, Medicaid, and Payer applications.
• HIPAA knowledge as applies to contracting, credentialing, and enrollment for health care entities and/or health care professionals.
• Ability to create and maintain profiles in PECOS, CAQH, NPPES, Availity, and other databases as required.
• Ability to learn and navigate credentialing software
• Ability to support multiple team members and Client Projects simultaneously and prioritize in a fast-paced environment
• Ability to multi-task and work independently.
• Must have excellent communication skills and ability to interact with a diverse population.
• Strong team working and collaborative skills.
• Demonstrate sound judgment, handle confidential information and always keep a professional demeanor

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the associate for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Education and Experience:

Must possess strong interpersonal skills with a high sensitivity to the needs of others, including the ability to communicate effectively with staff, administrators, providers and payors.

• Must have high school diploma or equivalent
• Associate's degree or higher preferred
• NAMSS CPCS or CPES certification(s) preferred (National Association of Medical Staff Services)
• Preferred minimum of two year's experience in Medical Staff Office setting, (i.e. contracting, credentialing, and enrollment for health care professionals and/or organizations).
• Professional organizational skills, written and oral communication and customer service skills, particularly in dealing with personal interactions.
• Demonstrated ability and experience in computer applications (MS office products), use of electronic medical record keeping systems and MS Office. Comprehensive understanding of medical terminology.

Work Shift :

Scheduled Weekly Hours :