Senior Credentialing Coordinator
About The Position
The Credentialing Specialist coordinates credentialing activities and applies analytical and critical-thinking skills when credentialing and re-credentialing applicants. The role serves as a liaison between credentialing staff and administration within parameters established by the Credentialing Manager, Chair, designee, or CMO. Under the direction of the Credentialing Supervisor, the specialist processes initial and re-credentialing applications for physicians, mid-level providers, dentists, and other applicable providers. The position ensures accurate, complete, and timely credentialing processes; prepares credentialing files for presentation to the Credentialing Committee and for State Agency and Health Plan audits; and supports Credentialing Coordinators in developing their skills and experience.
Requirements
- High school diploma required.
- Minimum of 5 years of experience in Health Care (Managed Care, MSO, Medical Staff) Credentialing or a related field required.
Nice To Haves
- Associate's degree and/or college coursework highly preferred.
- Certified Provider Credentialing Specialist (CPCS) preferred.
Responsibilities
- Coordinate credentialing activities and credentialing functions.
- Use analytical and critical-thinking skills when credentialing and re-credentialing applicants.
- Act as a liaison between credentialing staff and administration within established parameters.
- Process initial and re-credentialing applications for physicians, mid-level providers, dentists, and other applicable providers.
- Ensure credentialing and re-credentialing processes are accurate, complete, and timely.
- Prepare credentialing files for presentation to the Credentialing Committee and for State Agency and Health Plan audits.
- Support Credentialing Coordinators in gaining skills and experience.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- 403(b) retirement savings plan with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career advancement and development opportunities
- Paid Time Off and holidays
- Paid CME days
- Malpractice insurance and tail coverage
- Tuition reimbursement program
- Corporate employee discounts
- Employee referral bonus program
- Pet care insurance
- The role may qualify for discretionary bonuses or incentives.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
