Credentialing Specialist

Grand Peaks • ID

91d

About The Position

Join Our Growing Team at Grand Peaks! Grand Peaks is growing and expanding our services to better serve our community. We are seeking a dedicated Credentialing Specialist to join our administrative team in St. Anthony. At Grand Peaks, we take pride in providing exceptional, compassionate care and that starts with having an outstanding team behind the scenes. The Credentialing Specialist is responsible for managing all aspects of credentialing, privileging and re-credentialing for providers and clinical staff. This position plays a key role in ensuring that all credentials and certifications are accurate, up to date, and compliant with federal, state, and payer requirements.

Requirements

• High school diploma or equivalent required; associate’s or bachelor’s degree preferred
• Previous experience in credentialing, provider privileging, payer enrollment, billing or healthcare administration preferred
• Experience using credentialing software preferred
• Knowledge of credentialing standards preferred
• Knowledge of insurance payer requirements
• Strong organizational skills with exceptional attention to detail
• Excellent communication and follow-up skills
• Proficiency with integrated computer software and cloud based systems

Responsibilities

• Coordinate and complete credentialing, privileging and re-credentialing applications for all providers and clinical staff
• Verify and maintain current provider credentials, licenses, and certifications
• Track renewals and ensure ongoing compliance with regulatory and payer standards
• Communicate with providers, clinical staff, insurance payers, local hospital privileging offices and regulatory agencies regarding credentialing status
• Maintain and update credentialing databases and documentation
• Update EMR with license expiration dates
• Clinic credentialing / payer & clearinghouse enrollment
• Utilize credentialing software to manage and track credentialing processes
• Assist with all clinical staff onboarding and support the HR and administrative teams as needed

Benefits

• Competitive pay
• Health insurance
• Paid time off
• Retirement options

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees