Credentialing Specialist

Fabric•New York, NY

36d•$50,000 - $75,000

About The Position

The Credentialing Specialist will be an integral member of the team, responsible for managing the internal and external credentialing process for our medical staff. This role is crucial for managing and verifying provider credentials, monitoring and reviewing monthly expiring documents (expirables), and maintaining provider profiles in our Credentials Maintenance System. Your expertise will be essential in ensuring continuous compliance with company, state, federal, and regulatory guidelines, and you will be a key liaison coordinating with outside vendors and customers.

Requirements

Bachelor’s degree or minimum of 2 years experience in medical licensing and/or credentialing.
Attention to detail and ability to manage multiple tasks simultaneously.
Ability to work independently and as part of a team.
Excellent organizational and time management skills.
Excellent communication and interpersonal abilities.
An understanding of medical credentialing requirements.

Nice To Haves

Knowledge of credentialing terminology.

Responsibilities

Licensing Applications: Request and facilitate initial and renewal licensing applications, ensuring compliance with all state and federal regulations.
Supervisory Agreements: Pre-fill and complete State and employer specific Supervisory Agreements as required.
Records Management: Maintain accurate and up-to-date credentialing files and records in credentialing systems, actively tracking expiration dates and renewal deadlines.
Proactive Compliance: Proactively track and process renewals for licenses and certifications, conduct audits, and report compliance status to leadership.
Verification: Review and verify professional licenses, certifications, education, work experience, etc.
Vendor Profile Management: Maintain accurate and up to date clinician vendor profiles and ensure timely completion of vendor new and renewal licensing application requests.
Audit Support: Request and distribute Malpractice COI’s and assist with internal and external audits by providing or collecting necessary documentation.
External Coordination: Assist with customer and payor applications.