Medical Credentialing Specialist

Tareen Dermatology PA•Roseville, MN

6d•$21 - $30•Hybrid

About The Position

Tareen Dermatology is actively hiring for a Medical Credentialing Specialist. This role will be responsible for credentialing/re-credentialing all current and future practitioners, practitioner & location payer credentialing, and ensuring all licenses are active and updated. This position is primarily remote but requires candidates to live within the Twin Cities Metro and be available for occasional on-site meetings.

Requirements

High school diploma or equivalent required
1-2 years of experience in credentialing role within a healthcare setting required.
Proficient in typing, spelling, punctuation, grammar, and oral communication.
Ability to manage multiple priorities.
Detail oriented and highly organized.
Ability to follow oral and written instructions.
Strong computer skills.
Ability to work well independently and as part of a team.
Prior credentialing experience within a medical office/clinic required.
Ability to communicate calmly and clearly with payers and others on the phone and in-person.
Ability to prioritize tasks effectively.
Ability to navigate Practice Management and EHR systems.

Nice To Haves

Previous dermatology experience preferred.

Responsibilities

Credentialing/re-credentialing of current and future practitioners.
Credentialing/re-credentialing for dispensary services.
Submit necessary documents to insurance payers in a timely manner to ensure efficient processing.
Submit change request forms to payers for payer established new hires allowing for enough time to credential prior to start date.
Location credentialing for new clinics.
Create and keep up to date credentialing progress logs for new hires pending credentialing.
Maintain updated credentialing contact list per insurance plan.
Update practitioner NPI information on NPPES as needed.
Obtain updated medical licenses, DEA certificates, and board certifications from practitioners.
Verify updated medical licenses, DEA certificates, and board certifications.
Update insurance payers with current malpractice and license documents prior to document expropriation.
Term former practitioners from networks as appropriate.
Update and distribute insurance lists as changes occur.
Troubleshoot credentialing insurance issues with billing/insurance staff and supervisor as needed.
Updates job knowledge by participating in educational opportunities.
Follow HIPAA and OSHA policies.
Other duties as assigned.