Medical Credentialing Specialist

Tareen Dermatology PA•Roseville, MN

4d•$21 - $30•Hybrid

About The Position

Tareen Dermatology is hiring a full-time, non-exempt Medical Credentialing Specialist. The position is primarily remote, but applicants must live in the Twin Cities Metro and be available for occasional on-site meetings. The specialist is responsible for credentialing and re-credentialing current and future practitioners, credentialing practitioners and locations with payers, and ensuring licenses and related documents are current. The role works with insurance payers, practitioners, billing and insurance staff, and a supervisor to support timely and accurate credentialing.

Requirements

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

Nice To Haves

Previous dermatology experience.

Responsibilities

Credential and re-credential current and future practitioners.
Credential and re-credential dispensary services.
Submit necessary documents to insurance payers in a timely manner.
Submit payer change request forms for new hires early enough to allow credentialing before their start dates.
Complete location credentialing for new clinics.
Create and maintain credentialing progress logs for new hires with pending credentialing.
Maintain an up-to-date credentialing contact list for each insurance plan.
Update practitioner NPI information on NPPES as needed.
Obtain and verify practitioners’ current medical licenses, DEA certificates, and board certifications.
Update insurance payers with current malpractice and license documents before those documents expire.
Terminate former practitioners from payer networks as appropriate.
Update and distribute insurance lists as changes occur.
Troubleshoot credentialing and insurance issues with billing and insurance staff and the supervisor as needed.
Maintain job knowledge by participating in educational opportunities.
Follow HIPAA and OSHA policies.
Perform other duties as assigned.