Credentialing Specialist I

Beacon Oral Specialists•Dallas, TX

1d•Onsite

About The Position

Are you looking for a company that you can call home and have opportunities to grow? We are looking for a Credentialing Specialist to join our growing organization. As a Credentialing Specialist, you'll work closely with a variety of healthcare organizations to ensure the credentials of medical professionals are impeccable. By verifying and auditing credentials, you'll be part of a team devoted to upholding standards of excellence and providing the highest level of care to patients.

Requirements

High school diploma or equivalent required.
Minimum of 2 years of experience in credentialing or provider enrollment in a healthcare setting required.
Strong knowledge of industry regulations, such as the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC) standards.
Proficient in using credentialing software and databases for data entry and maintenance.
Excellent attention to detail and ability to work with complex documents.
Strong analytical and problem-solving skills.
Exceptional organizational and time management abilities.
Effective communication and interpersonal skills.
Ability to work independently and collaboratively within a team.
Proficient in Microsoft office applications including Word, Excel, and Outlook.
Professional voice inflection and direct eye contact.
Professional business attire, appearance, and phone etiquette.
Belief in practice treatment and fees.

Nice To Haves

Experience working in a dental or surgical setting preferred.

Responsibilities

Manage the credentialing process for healthcare providers, including physicians, nurses, and other licensed professionals.
Verify the accuracy and completeness of provider applications, ensuring that all required documents are submitted.
Conduct thorough background checks, license verifications, and references to ensure compliance with regulatory standards.
Coordinate with internal departments and external agencies to obtain and update relevant provider information.
Maintain accurate and up-to-date electronic and hard copy files of all credentialing documentation.
Communicate with providers to address any discrepancies or missing information.
Monitor expiring licenses and credentials, proactively initiating the renewal process to avoid any disruption in services.
Stay up-to-date with industry regulations and requirements, ensuring compliance at all times.
Assist in preparing for and participating in audits and regulatory reviews.
Provide support and guidance to internal staff regarding credentialing and privileging processes.
Any other duties assigned.