Healthcare Credentialing Specialist (Ancillary/Facilities)

Job Title : Healthcare Credentialing Specialist (Ancillary/Facilities)

Reporting To : Client

Employment Status : Full Time

Work Schedule : 8AM-5PM Pacific Standard Time

Benefits : Full Benefits upon Regularization

Overall Job Description

The Healthcare Credentialing Specialist is responsible for enrolling healthcare providers credentialed with Medicaid programs as well as commercial insurance payors. It also oversees the initial client set up for new practices and maintains a current database of credentials and enrollment information. This position is responsible for enrollment processes for medical providers at healthcare clinics and hospital-based groups.

Job Responsibilities
  • Manage the credentialing needs for our clients. 
  • Responsible for collecting all the required documentation for credentialing such as accreditation, membership, and facility privileges. 
  • Accurately complete payer credentialing and facility appointment applications for providers.
  • Assist providers with completing payer forms and ensure compliance with payer’s expectations. 
  • Maintain accurate and current client information.
  • Alert clients about new regulations, expiring certificates, reapplications, and deficiencies in credentialing requirements.
  • Provides support and assistance for new practice setup as needed.
  • Track progress of outstanding applications and communicate with provider relation representatives ensuring enrolment completion.
  • Maintains credential files in an orderly and current manner.
  • Provides research and administrative support for special projects.
  • Ensures HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities.
  • Other duties may be assigned from time to time.
Desired Qualifications and Requirements:
  • Bachelor’s Degree Holder
  • Minimum of 2 Years of Healthcare Credentialing Specialist Experience performing Credentialing for Ancillaries such as Hospitals and other Facilities
  • Proficiency with Microsoft Applications
  • Highly organized with a strong attention to detail
  • Comfortable in a fast-paced environment
  • Approachable, professional, and discrete, and personable
  • Ability to provide high-quality customer service and follow through on all assignments
  • Can work under pressure and with minimal supervision
  • Ability to work with minimal supervision
  • Passion for service.
  • Has initiative and can meet deadlines
  • Can start ASAP!

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