Credentialing Specialist

Core Clinical Partners • Atlanta, GA

27d

About The Position

The Credentialing Specialist partners with medical providers, hospitals, insurance companies, operations leaders, and other stakeholders to ensure providers are credentialed. The role manages hospital and financial credentialing processes for new hires and existing providers, including documentation, communication, monitoring, and staying current with credentialing specifications.

Core Clinical Partners provides Emergency and Hospital Medicine services through a model emphasizing patient-centric care and operational excellence. Its stated corporate values are Genuine, Accountable, Dynamic, Respectful, and Fun. The company is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable. Duties and responsibilities may change at any time with or without notice.

Requirements

• High school diploma or GED.
• Prior administrative experience in a healthcare environment.
• Experience with MS Outlook, Word, and Excel.
• Knowledge of credentialing requirements and workflows for providers at differing client groups.
• Familiarity with healthcare jargon and terminology related to credentialing.
• Excellent verbal and written communication skills.
• Excellent interpersonal and customer service skills.
• Proficiency in Microsoft Office and credentialing-related software.
• Excellent organizational skills and attention to detail.
• Ability to work independently and exercise judgment in decision-making and issue resolution.
• Ability to navigate competing priorities and work effectively in a fast-paced environment.
• Ability to manage information flow in a timely and accurate manner.
• Ability to collaborate with professionals at various client groups and geographic locations.
• Ability to identify and execute opportunities for improvement.
• Growth mindset and team-oriented behaviors.

Nice To Haves

• Medical credentialing experience.
• Experience with MS Teams and credentialing software.

Responsibilities

• Stay abreast of credentialing and recredentialing requirements for each client group.
• Request, review, and verify credentialing applications and supporting documentation.
• Establish and maintain a database of provider details and credentialing data.
• Monitor provider license and certification expirations to ensure timely renewals.
• Notify providers and administration of upcoming expirations and documentation requests.
• Collaborate with hospitals, insurance companies, and other stakeholders to provide information and track the credentialing process.
• Provide status updates to operations leaders, providers, and other stakeholders.
• Resolve issues and escalate them when appropriate.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED