What are the responsibilities and job description for the Credentialing Specialist position at One GI®?
Credentialing Specialist, OneGI
Are you looking to join a company that values respect, integrity, accountability, and leadership? Do you want to be part of one of the nation’s leading providers of gastroenterology care? If so, One GI® may be the place for you—come join our family!
We are currently seeking a well-versed Credentialing Specialist to join our growing team. The ideal candidate brings strong knowledge of credentialing processes, attention to detail, and a commitment to supporting high-quality patient care through accurate and timely provider credentialing.
Who We Are
One GI® is a true collaboration of top-tier clinical and business professionals, united by a shared focus on what matters most: our patients. Every team member plays a vital role, and your contributions will make a meaningful impact.
Awesome Perks, Just for You!
Are you looking to join a company that values respect, integrity, accountability, and leadership? Do you want to be part of one of the nation’s leading providers of gastroenterology care? If so, One GI® may be the place for you—come join our family!
We are currently seeking a well-versed Credentialing Specialist to join our growing team. The ideal candidate brings strong knowledge of credentialing processes, attention to detail, and a commitment to supporting high-quality patient care through accurate and timely provider credentialing.
Who We Are
One GI® is a true collaboration of top-tier clinical and business professionals, united by a shared focus on what matters most: our patients. Every team member plays a vital role, and your contributions will make a meaningful impact.
Awesome Perks, Just for You!
- Excellent paid time off for a healthy work/life balance.
- We’ve got your future in mind! With our generous 401(k) plan, we’ll help you grow your nest egg with an employer match that makes saving for retirement even sweeter.
- Looking to further your education? We want to help! We offer education reimbursement opportunities, with generous annual support based on your employment status.
- Internal growth opportunities. We want to aide in your training and development.
- Competitive health and supplemental benefits; with FSA and HSA options.
- Love where you work? Spread the word! Refer a friend who’d be a great fit for One GI® and earn a special bonus when they join the team!
- Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, and local regulations, guidelines, policies, and standards.
- Conduct primary source verification, collect, and validate documents to ensure accuracy of all credentialing elements; assess completeness of information and qualifications relative to credentialing standards.
- Identify, analyze, and resolve information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners; discover and convey problems to Credentialing Manager.
- Maintain knowledge of current health plan and agency requirements for credentialing providers.
- Track license and certification expirations for all providers to ensure timely renewals and assists in submitting license and DEA registration renewal applications where desired.
- Assist in securing and maintaining enrollment with currently contracted plans as well as newly contracted plans upon identification.
- Assist in securing and maintaining facility affiliation where appropriate.
- Seek assistance from Payers regarding claims identified by the follow up team as having processed out of network.
- Thorough knowledge of compliance with state and federal laws, including HIPAA, required.
- High School Diploma or equivalent required
- Minimum of two (2) years focused provider credentialing or provider enrollment experience.
- Working knowledge of Provider Enrollment portals including but not limited to CAQH, NPDB, Identity & Access Management, NPPES, PECOS, and Availity.
- Experience in performing primary data source verifications.
- Specific knowledge of provider credentialing and payer enrollment process
- Facility Credentialing/ Medical Staff Services experience, preferred.