Credentialing Specialist

Sanford • Sioux Falls, SD

264d • $21 - $34

About The Position

The Credentialing Specialist is responsible and accountable for oversight of tasks and processes developed to facilitate the credentialing process for initial and reappointment applications to medical staff, professional health staff and allied health staff. This role involves overseeing the timelines and workflow processing of the reappointment cycles, prioritizing work to meet anticipated start dates and reappointment expiration, and ensuring the completeness of applications while identifying issues requiring additional information or investigation. The specialist will oversee the accuracy of application data entry and verification requests, perform the final review of processed verifications for quality and content, and develop correspondence to obtain additional information as needed. Additionally, the specialist will facilitate committees in preparation of agenda materials and follow-up on recommendations, coordinate communication of final credentialing recommendations to all parties, generate audits and reports to support/document the verifications and credentialing process, facilitate projects, and initiate the provider application process. The role requires excellent customer service skills and the ability to communicate effectively and diplomatically with providers.

Requirements

• Bachelor's degree required.
• In lieu of education, leadership may consider an Associate's degree and 3 years of applicable experience.
• Minimum of two years of experience in credentialing, provider services, administrative support, business or healthcare experience preferred.

Responsibilities

• Oversee the timelines and workflow processing of the reappointment cycles.
• Prioritize work to meet anticipated start dates and reappointment expiration.
• Accountable for the completeness of applications and identifying issues requiring additional information or investigation.
• Oversee the accuracy of application data entry and verification requests.
• Perform the final review of processed verifications for quality and content.
• Develop correspondence to obtain additional information as needed.
• Facilitate committees in preparation of agenda materials and follow-up on recommendations.
• Coordinate communication of final credentialing recommendations to all parties.
• Generate audits and reports to support/document the verifications and credentialing process.
• Facilitate projects and initiate the provider application process.

Benefits

• Development and advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Merchant Wholesalers, Nondurable Goods
• Education Level: Bachelor's degree