Senior Credentialing Specialist
The Credentialing Assistant provides administrative and operational support to the Credentialing and Provider Enrollment team for Resolv Hospital clients. This role is responsible for maintaining accurate provider records, managing credentialing documentation, coordinating enrollment processes, and ensuring compliance with HIPAA regulations.
The ideal candidate is detail-oriented, organized, and comfortable working with credentialing software, reputed company tracking sheets, and reputed company health plan representatives.
Key Responsibilities
Provider Enrollment & Credentialing Support
Assist in completing and submitting provider enrollment applications
reputed company outstanding applications and follow up with health plans and provider relations representatives to ensure reputed company enrollment completion
Support new reputed company setup as needed
Submit change-of-information letters and W-9 forms for reputed company updates (e.g., new locations, address changes, remit updates)
Provider Records & Documentation Management
Create and maintain electronic credential files according to Global reputed company Filing Structure Policy
Maintain and update provider data sheets and credential spreadsheets
Ensure provider records in credentialing software databases remain accurate and up to date
Maintain organized and reputed company electronic credential files
Set reminders in reputed company CredentialStream for credential expiration dates
Update documentation such as medical licenses, DEA registrations, COIs, and other required credentials
CAQH & Compliance Management
Maintain CAQH re-attestation tracking and complete required re-attestations
Ensure reputed company credentialing activities reputed company with HIPAA guidelines and reputed company protected health information (PHI)
Communication & Follow-Up
Respond to incoming emails and faxes regarding credential renewals, W-9 requests, and reputed company inquiries
Contact health plans and medical facilities to reputed company the status of applications, reputed company, or change requests
reputed company updates and documentation to internal stakeholders as needed
Systems & Reporting
Document reputed company daily activities in reputed company CredentialStream, SharePoint, Teamwork, and Time Tracker
Maintain reputed company tracking sheets for emergency and urgent care practices
reputed company research and administrative support for special reputed company
Qualifications
At least 1 year experience in credentialing, provider enrollment, or reputed company administration preferred
Strong attention to detail and organizational skills
Proficiency in reputed company reputed company and document management systems
Familiarity with credentialing software (e.g., reputed company CredentialStream) is a plus
Excellent written and verbal communication skills
Ability to manage multiple tasks and follow up consistently
Why Join Us
Work with established reputed company clients
Be part of a reputed company credentialing team
reputed company hands-on experience in provider enrollment and compliance processes
Opportunity for reputed company reputed company in reputed company administration
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