Credentialing Specialist

• Act as a liaison between providers, credentialing companies, and insurance entities to collect necessary documentation for credentialing processes, including licenses, certificates, and other essential information
• Maintain up-to-date provider files, ensuring proper documentation for licensing, hospital privileges, malpractice liability certificates, and other required credentials
• Verify hospital affiliations and ensure all requirements are met for providers’ active and current affiliations
• Submit provider credentials to insurance payers, hospitals, and credentialing firms as required
• Organize and manage detailed records of credentialing documents and receivables using designated systems or drives
• Analyze operational data, including co-pays, deductibles, underpayments, and denial reasons, to identify and address discrepancies
• Ensure all fees, permits, and renewals are processed accurately and kept current to maintain compliance
• Obtain signatures and approvals from relevant parties to finalize credentialing and re-credentialing processes

• Proven experience in credentialing processes, including provider licensing and insurance compliance
• Proficiency in Microsoft Excel and other record-keeping tools
• Strong organizational skills with the ability to manage multiple priorities and deadlines
• Excellent communication skills to liaise effectively with providers, insurance companies, and credentialing firms
• Attention to detail and accuracy in managing sensitive documentation
• Ability to analyze data and address discrepancies efficiently
• Knowledge of hospital affiliation processes and credentialing requirements
• Familiarity with insurance and payer systems is highly desirable

Familiarity with insurance and payer systems

• medical, vision, dental, and life and disability insurance
• eligible to enroll in our company 401(k) plan