Credentialing Specialist

LOUISIANA ORTHOPAEDIC SPECIALISTS LLC • Lafayette, LA

5d • Remote

About The Position

We are seeking a detail-oriented Credentialing Specialist to join our healthcare team, focusing on orthopaedic provider credentialing. This remote position plays a crucial role in maintaining the highest standards of patient care and regulatory compliance by managing the credentialing process for our orthopaedic healthcare providers.

Requirements

• Minimum of 2 years' experience in healthcare credentialing
• Demonstrated proficiency in electronic credentialing management systems
• Strong understanding of healthcare regulations and accreditation standards
• Excellent organizational skills with exceptional attention to detail

Nice To Haves

• NAMSS Certification (CPCS or CPMSM)
• Experience with Louisiana State Board of Medical Examiners (LSBME), Louisiana Board of Nursing and Pharmacy
• Demonstrated proficiency with Louisiana Medicaid and MCO credentialing requirements
• Familiarity with the Council for Affordable Quality Healthcare (CAQH)
• Experience with Louisiana hospital privileging systems
• Understanding of Louisiana Workers' Compensation Medical Treatment Guidelines for orthopaedic care
• Familiarity with the Louisiana Uniform Credentialing Program

Responsibilities

• Managing the comprehensive credentialing lifecycle for providers, including initial applications, reappointments, and ongoing monitoring of compliance requirements
• Conducting thorough primary source verification of medical education, training, licensure, and board certifications
• Maintaining detailed digital records and updating credentialing databases with precision and timeliness
• Coordinating with insurance payers for provider enrollment and network participation
• Proactively tracking and managing credential renewal deadlines to ensure continuous compliance
• Investigating and resolving credentialing discrepancies through appropriate channels
• Generating regular status reports and compliance updates for leadership review

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed