Credentialing

Job Summary
We are seeking a detail-oriented and highly organized Credentialing Assistant to join our healthcare administration team. The ideal candidate will possess a strong understanding of managed care processes, medical office procedures. In this role, you will be responsible for verifying provider credentials, maintaining accurate credentialing records, and ensuring compliance with regulatory requirements. Your expertise will support the delivery of high-quality healthcare services by facilitating smooth credentialing operations and fostering trust within our network.

Duties

• Review and verify provider credentials, including licenses, certifications, and educational qualifications, to ensure compliance with organizational and regulatory standards.
• Manage the credentialing process from initial application through re-credentialing, maintaining detailed documentation at each stage.
• Collaborate with managed care organizations, hospitals, and other healthcare entities to facilitate credentialing approvals and renewals.
• Ensure adherence to Credentialing standards by maintaining up-to-date credentialing files and supporting accreditation audits.
• Maintain accurate databases of provider information, tracking expiration dates and renewal deadlines proactively.
• Coordinate with medical offices to gather necessary documentation and resolve discrepancies or issues promptly.
• Support quality assurance initiatives by auditing credentialing files regularly and implementing process improvements.

Skills

• Strong knowledge of managed care systems, provider credentialing processes, and healthcare regulations.
• Prior experience working within a medical office environment or healthcare administration setting.
• Proficiency in medical terminology to accurately interpret credentials and licensing documents.
• Familiarity with standards and accreditation requirements related to provider credentialing.
• Excellent organizational skills with meticulous attention to detail and accuracy.
• Effective communication skills for liaising with providers, insurance companies, and internal teams.
• Ability to manage multiple priorities efficiently in a fast-paced healthcare setting. Join our team as we uphold the highest standards of provider verification and contribute to delivering exceptional healthcare services through precise credentialing practices.
• Effective oral and written skills; general report writing skills.
• Telephone courtesy; customer-service oriented.
• Modern office practices and procedures including email.
• Intermediate to expert user computer skills.
• Highly organized.
• History and proven record of effective program/project management.
• Attention to detail and excellent follow-through on work tasks.
• Demonstrates good problem-solving skills.
• Able to track multiple tasks and complete promptly.
• Able to quickly build and maintain rapport with employees and providers of differing backgrounds; team player.

Minimum Requirements:

Education:

• High School Diploma or GED

Prior Experience:

• Two to four years’ experience in progressively responsible credentialing positions.

Physical Requirements:

• Must be able to move up to 20 pounds and push up to 50 pounds (on wheels).
• Must be able to hear staff on the phone and those who are served in-person, and speak clearly in order to communicate information to clients and staff.
• Must be able to have vision that is adequate to read memos, a computer screen, personnel forms and clinical and administrative documents.
• Must have high manual dexterity.
• Must be able to reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouching, reaching, kneeling, twisting/turning, fingering and feeling.

Job Type: Full-time

Pay: $21.00 - $22.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• AD&D insurance
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $21 - $22