Senior Credentialing Specialist- Managed Care

VHC Health • Alexandria, VA

1d

About The Position

The Senior Credentialing Specialist for Managed Care acts as the lead within the Credentialing Specialist team, supporting complex and high-volume credentialing and enrollment processes for physicians and advanced practice providers within insurance plans. The role involves coordinating team efforts, facilitating credentialing tasks with government and commercial payers to expedite effective dates of insurance participation for new and existing providers. Ensures data integrity in various systems for successful re-credentialing and compliance.

Requirements

• At least two years of insurance plan credentialing experience in a physician practice, hospital, or managed care setting
• demonstrated ability to lead projects or small teams

Nice To Haves

• Bachelor's degree in a healthcare related field is preferred.
• Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) is preferred.

Responsibilities

• supporting complex and high-volume credentialing and enrollment processes for physicians and advanced practice providers within insurance plans
• coordinating team efforts
• facilitating credentialing tasks with government and commercial payers to expedite effective dates of insurance participation for new and existing providers
• Ensures data integrity in various systems for successful re-credentialing and compliance

What This Job Offers

• Career Level: Mid Level