Credentialing Specialist

Description: We are currently seeking a Credentialing Specialist who is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages.
Responsibilities and Duties: Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing and re-credentialing applications. Compiles and maintains current and accurate data for all providers. Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers. Maintains corporate provider contract files. Ensures practice addresses are current with health plans and contracts as needed. Applying for in-network contract with various insurance carriers. Maintains confidentiality, security, and physical safety of any Provider, Plan, and PHI data. Credential new providers and re-credential current providers with hospitals at which they hold staff privileges.
Requirements: Required/Preferred Qualifications: 1 year credentialing experience preferred. High school diploma/equivalent. Healthcare Credentialing experience is a plus. Must possess a strong proficiency with Microsoft Office Suite (Word/Excel/Outlook/PowerPoint). Medical Terminology. Must have knowledge with Credentialing databases such as MD Staff. Strong knowledge of Medical Contracts and negotiating. Versatile, flexible, and willing to work within a dynamic environment. Candidate must pass a background check. Medicaid, Medicare, CAQH, and Availity knowledge is a plus. Schedule This position reports to the Business Office Director. The schedule is M-F, 8:30AM-5PM.
Apply today Apply on pedimhealthcare.com, click on Our People, click on Careers
Or send resume and cover letter to Emily Rizzo, HR Manager, at
PM20 EOE Compensation details: 16-19 Hourly Wage


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