Responsibilities:

• Provider Credentialing: Manage the credentialing process for healthcare providers joining or affiliated with the organization. This includes verifying licenses, certifications, education, training, and relevant experience.
• Compliance: Ensure compliance with all regulatory requirements, accreditation standards
• Provider Enrollment: Oversee the enrollment process for providers with insurance plans and government programs, ensuring timely and accurate submission of credentialing applications.
• Database Management: Maintain accurate and up-to-date provider credentialing information in the credentialing database or software system.
• Credentialing Committee Support: Facilitate credentialing committee meetings, prepare materials, and present credentialing files for review and approval.
• Communication: Serve as the primary point of contact for providers regarding credentialing inquiries, status updates, and documentation requirements.
• Quality Assurance: Implement quality assurance processes to monitor the accuracy and completeness of credentialing files and documentation.
• Training and Education: Provide education and training to staff, providers, and credentialing committee members on credentialing processes, regulations, and best practices.
• Audits and Monitoring: Conduct internal audits and monitoring activities to identify areas for improvement and ensure compliance with credentialing standards.
• Collaboration: Collaborate with various departments

Qualifications:

• At least 3-5 years of experience in healthcare credentialing or related field, with progressive responsibility preferred.
• Strong knowledge of healthcare regulations, accreditation standards, and credentialing processes.
• Excellent organizational, communication, and problem-solving skills.
• Proficiency in credentialing software systems and Microsoft Office Suite.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
• Attention to detail and a commitment to accuracy and quality assurance.

Job Type: Full-time

Pay: $65,000.00 - $67,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Work Location: In person