What are the responsibilities and job description for the Credentialing Specialist position at Mid-Vermont Medical Billing?
Job Summary
We are seeking a detail-oriented and proactive Credentialing Specialist to join our company. In this vital role, you will manage the credentialing and re-credentialing processes for healthcare providers, ensuring compliance with industry standards and regulatory requirements.
Duties
- Review and verify provider credentials, licenses, certifications, and educational backgrounds in accordance with organizational policies and industry standards.
- Manage the entire credentialing lifecycle, including initial onboarding, re-credentialing, and ongoing monitoring to ensure timely updates.
- Collaborate with managed care organizations, hospitals, and licensing boards to obtain necessary documentation and maintain compliance with NCQA (National Committee for Quality Assurance) standards.
- Maintain detailed records of provider credentials using credentialing software systems, ensuring data accuracy and confidentiality.
- Coordinate with medical offices to gather required documentation such as malpractice insurance, DEA registrations, and board certifications.
- Monitor credential expiration dates proactively and initiate renewal processes ahead of deadlines to prevent lapses in provider privileges.
- Assist in preparing reports related to credentialing status, compliance audits, and accreditation requirements.
Experience
- Proven experience in medical office administration or healthcare credentialing is highly preferred.
- Strong understanding of managed care processes and requirements for provider credentialing.
- Familiarity with medical terminology and healthcare documentation standards.
- Knowledge of NCQA standards and accreditation processes related to provider credentialing is a significant advantage.
- Excellent organizational skills with attention to detail; ability to manage multiple tasks simultaneously.
- Effective communication skills for collaborating with providers, administrative staff, and external organizations.
Join us in ensuring that our healthcare providers meet the highest standards of quality and compliance! This paid position could become full-time, depending on the need of new and existing clients.
Pay: $25.00 - $28.00 per hour
Experience:
- Credentialing: 1 year (Required)
Work Location: Hybrid remote in Rutland, VT 05701
Salary : $25 - $28