Credentialing Specialist

CHARTER OAK HEALTH CENTER INC•Hartford, CT

6d•Onsite

About The Position

Charter Oak Health Center is seeking a Credentialing Specialist to join their team. This role is responsible for credentialing clinical staff, managing enrollment with commercial vendors, and handling clerical tasks and special projects as needed. The position requires adherence to legal requirements, policies, and procedures, including HIPAA, and participation in orientation, training, and process improvement activities. Reporting of non-compliance issues and cooperation with audits and investigations are also part of the responsibilities.

Requirements

Proficiency in Microsoft Office and Outlook
Strong typing skills
Strong interpersonal skills
Strong communication skills
Strong organizational skills
Strong follow-up skills
High school diploma required

Nice To Haves

Associate's degree preferred
1-2 years of credentialing or privileging experience in a healthcare setting is preferred
Credentialing Specialist Certification preferred

Responsibilities

Verify provider credentialing applications and documentation (education, employment, licenses, certifications).
Perform background checks including NPDB, OIG Exclusion List, and AMA profiles.
Prepare documentation for initial and reappointment of privileges for the Credentialing Committee.
Update the credentialing roster and provider carrier enrollment list daily.
Coordinate provider enrollment and maintenance with Medicaid, Medicare, and commercial insurances.
Assist with credentialing software implementation and maintenance.
Maintain confidentiality of credentialing data.
Perform additional duties as needed and maintain good attendance.