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SOUTH HEART CLINIC
HARLINGEN, TX | Full Time
$38k-48k (estimate)
Just Posted
South Heart Clinic, PLLC
Harlingen, TX | Full Time
$38k-48k (estimate)
Just Posted
Credentialing Specialist
SOUTH HEART CLINIC HARLINGEN, TX
$38k-48k (estimate)
Full Time Just Posted
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SOUTH HEART CLINIC is Hiring a Credentialing Specialist Near HARLINGEN, TX

Credentialing SpecialistPosition Summary: This position is responsible for managing provider enrollment, credentialing, re-credentialing, and enrollment for multiple providers. The position maintains up-to-date data for each provider in credentialing databases and online systems and ensures timely license and certification renewals.ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:
  • Oversees the accurate collection of provider documents and information needed to contract and credential providers with insurance plans.
  • Responsible for submitting initial and recredentialing applications to payers.
  • Manages multiple provider CAQH profiles, responds and completes attestations and verification related to providers.
  • Monitors applications and follows up as required and is able to respond to provider and department leadership related to the status of applications.
  • Identifies and maintains relationships with payer representatives to assist in any issues.
  • Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
  • Stay current on health plans.
  • Tracks license, DEA and professional liability expirations for providers.
EXPERIENCE:Two years of relevant payer enrollment, as well as CAQH and managed care contracting experience, is preferred.SKILLS:
  • Knowledge and understanding of the credentialing process.
  • Ability to organize and prioritize work and manage multiple priorities.
  • Excellent verbal and written communication skills, including letters, memos, and emails.
  • Excellent attention to detail.
  • Ability to research and analyze data.
  • Ability to work independently with minimal supervision.
  • Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
  • Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.

Job Summary

JOB TYPE

Full Time

SALARY

$38k-48k (estimate)

POST DATE

06/01/2024

EXPIRATION DATE

08/27/2024

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The job skills required for Credentialing Specialist include Microsoft Office, Managed Care, Written Communication, Leadership, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing Specialist. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist. You can explore the career advancement for a Credentialing Specialist below and select your interested title to get hiring information.

South Heart Clinic, PLLC
Full Time
$38k-48k (estimate)
Just Posted

If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Credentialing Specialist job description and responsibilities

A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.

03/14/2022: Des Moines, IA

A credentialing specialist can have certificates that will prove useful to their field.

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Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.

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Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.

02/01/2022: Las Cruces, NM

Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.

01/18/2022: Pueblo, CO

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Credentialing Specialist jobs

Credentialing specialists can often find work with a high school diploma or the equivalent.

01/25/2022: Kingsport, TN

Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.

03/01/2022: Parkersburg, WV

While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.

12/25/2021: Little Rock, AR

Make Use Of Advanced Software For Monitoring.

01/18/2022: New London, CT

Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.

01/31/2022: Portsmouth, OH

Step 3: View the best colleges and universities for Credentialing Specialist.

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