What are the responsibilities and job description for the Credentialing Specialist position at Prophylaxis HealthCare?
Company Overview
Prophylaxis HealthCare is dedicated to providing exceptional, comprehensive care to the community it serves. As a family-owned and operated organization, we prioritize treating the whole patient—body, mind, and spirit—embodying our motto, “Prescribing more than medicine.”
Overview
We are seeking a proactive and detail-oriented Credentialing Specialist to join our team. In this vital role, you will manage the credentialing process for healthcare providers, ensuring compliance with industry standards and facilitating smooth onboarding. Your expertise will help uphold our commitment to delivering high-quality care by maintaining accurate provider credentials and supporting regulatory requirements.
Duties
- Review and verify provider credentials, licenses, certifications, and other required documentation in accordance with NCQA (National Committee for Quality Assurance) standards.
- Coordinate with healthcare providers, insurance companies, and licensing boards to obtain necessary credentialing information.
- Maintain up-to-date records of provider credentials and re-credentialing schedules to ensure ongoing compliance.
- Assist with the onboarding process for new providers by preparing credentialing packets and tracking progress through each step.
- Ensure adherence to managed care policies and industry regulations during credentialing activities.
- Collaborate with medical office staff to support smooth provider credential management and resolve any discrepancies or issues promptly.
- Prepare reports on credentialing status and assist in audits related to provider credentials and compliance standards.
Requirements
- Proven experience in managed care or medical office settings with a strong understanding of healthcare credentialing processes.
- Familiarity with medical terminology, NCQA standards, and industry regulations governing provider credentials.
- Excellent organizational skills with keen attention to detail to maintain accurate records and meet deadlines.
- Strong communication skills for liaising effectively with providers, insurance carriers, and regulatory agencies.
- Ability to work independently while managing multiple tasks efficiently in a fast-paced environment. Join us at Prophylaxis HealthCare and be part of a team committed to excellence in patient care! Your dedication will directly support our mission of delivering compassionate, comprehensive health services while ensuring our providers meet the highest standards of credentialing compliance.
Pay: $20.00 - $24.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $20 - $24