Credentialing Specialist

Healthcare South - Rockland, MA

Part-time - Entry Level

Rockland, MA

Ambulatory Health Care Services

About the position

Healthcare South is seeking an experienced Credentialing Specialist to join their Billing team at the corporate office in Rockland, MA. This part-time position involves managing the credentialing and re-credentialing processes for healthcare providers, ensuring compliance with health plans and hospital requirements. The role includes maintaining accurate provider data, tracking license renewals, and supporting the overall efficiency of the billing department.

Responsibilities

• Compile and maintain current and accurate data for all providers.
• Complete provider credentialing and re-credentialing applications; monitor applications and follow-ups as needed.
• Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers.
• Track license and certification expirations for all providers to ensure timely renewals.
• Maintain corporate provider contract files.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.
• Set up and maintain provider information in online credentialing databases systems.
• Ensure practice addresses are current with health plans, agencies, and other entities.
• Maintain confidentiality of provider information.
• Interact with fellow employees to promote a harmonious and cooperative working environment.
• Coordinate efforts to effectively work with others in a productive manner.
• Utilize spare time in work-related activities that contribute to the billing site's needs.
• Attend staff meetings as required and insurance seminars when necessary.
• Maintain proper attendance and punctuality.

Requirements

• High School Diploma / GED required; Associate's degree or higher preferred.
• 2-5 years of relevant credentialing experience.
• Experience with data entry.
• Proficient use of Microsoft Office applications (Word and Excel).
• Knowledge and understanding of the credentialing process.
• Knowledge of techniques for processing insurance claims.
• Typing speed of 35 wpm with 98 percent accuracy.
• Ability to follow verbal and written instructions.
• Ability to research and analyze data.
• Ability to organize workload to determine priority of duties.
• Ability to examine reports and insurance documents for accuracy.
• Ability to communicate effectively and work with others.

Nice-to-haves

• Experience in a healthcare setting.
• Familiarity with credentialing databases and systems.

Benefits

• 401(k)
• 401(k) matching
• AD&D insurance
• Life insurance
• Paid time off