What are the responsibilities and job description for the Medical Credentialing Specialist position at Whole Mind?
Job Overview
As a Medical Credentialing Specialist, you will play a pivotal role in ensuring that healthcare providers meet the necessary qualifications and standards to deliver exceptional care. You will be responsible for verifying credentials, maintaining compliance with regulatory requirements, and supporting the overall efficiency of the medical office. Your expertise in managed care and medical terminology will be essential as you navigate the credentialing process and uphold NCQA (National Committee for Quality Assurance) standards.
What you’ll do
- Conduct thorough verification of healthcare provider credentials, including education, training, and licensure.
- Maintain accurate and up-to-date records of provider information in compliance with NCQA standards.
- Collaborate with medical offices to gather necessary documentation and resolve any discrepancies.
- Monitor expiration dates of licenses and certifications to ensure ongoing compliance.
- Assist in the onboarding process for new providers by facilitating credentialing applications.
- Provide support during audits by preparing required documentation and responding to inquiries.
- Stay informed about changes in managed care policies and regulations that affect credentialing processes.
Basic qualifications
- Proven experience in a medical office setting with a strong understanding of medical terminology.
- Familiarity with managed care processes and requirements.
- Excellent organizational skills with attention to detail to ensure accuracy in documentation.
- Strong communication skills to effectively interact with healthcare providers and internal teams.
Preferred qualifications
- Previous experience working with NCQA standards or similar regulatory frameworks.
- Knowledge of electronic health record (EHR) systems and credentialing software.
- Ability to work independently while managing multiple tasks efficiently.
Why you’ll love it here
We are dedicated to fostering an environment where our team members can thrive both professionally and personally. Our commitment to your well-being is reflected in our comprehensive benefits package designed to support you at every stage of your career.
Our benefits include:
- Competitive pay structure
- Comprehensive health coverage options
- Retirement savings plans with employer contributions
- Opportunities for professional development and continuing education
About us
Join our dynamic team where we are committed to delivering high-quality healthcare services. We believe in empowering our employees through collaboration, innovation, and respect. Together, we can make a meaningful difference in the lives of those we serve!
Job Type: Full-time
Pay: $20.00 - $25.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
Work Location: In person
Salary : $20 - $25