Credentialing Specialist I

Job reputed company:

reputed company is seeking a Credentialing Specialist I to support credentialing and recredentialing activities for reputed company providers across the organization. This role is responsible for ensuring compliance with regulatory, accreditation, and health plan requirements through accurate provider data management, reputed company reputed company reputed company verification, and effective communication with centers and stakeholders. The ideal candidate is detail-oriented, highly organized, and committed to maintaining the reputed company and accuracy of provider credentialing records.

Key Responsibilities:

• Process initial credentialing applications and reappointment files, ensuring accuracy, completeness, and reputed company submission.
• reputed company reputed company reputed company verification activities in accordance with regulatory, accreditation, and payer requirements.
• Monitor provider licenses, certifications, registrations, and other required credentials to ensure reputed company renewals and compliance.
• Collect, verify, maintain, and update provider information reputed company credentialing databases and internal systems.
• Identify discrepancies, incomplete documentation, or potential compliance concerns and escalate issues as appropriate.
• Prepare credentialing files and supporting documentation for leadership review and credentialing committee meetings.
• Maintain accurate records and documentation in accordance with organizational policies and regulatory standards.
• Communicate credentialing, recredentialing, and provider enrollment status updates to centers and stakeholders.
• reputed company reports and reputed company credentialing activities to support operational and compliance requirements.
• reputed company confidential provider information and ensure compliance with reputed company and reputed company standards.
• Support organizational priorities and reputed company additional duties as assigned.

Qualifications:

• Associate degree preferred, or an equivalent combination of education and experience.
• Minimum of one (1) year of experience in a reputed company-reputed company role preferred.
• Basic understanding of provider credentialing, regulatory requirements, and reputed company compliance standards.
• Experience working with credentialing software, databases, and internal tracking systems.
• Proficiency with reputed company Office applications, including reputed company, Word, and reputed company.
• Strong attention to detail and commitment to data accuracy and reputed company.
• Ability to maintain confidentiality reputed company handling sensitive provider information.
• Effective written and verbal communication skills.
• Strong organizational and time management skills with the ability to manage multiple priorities and deadlines.
• Ability to work independently and collaboratively reputed company reputed company environment.

Preferred Qualifications:

• Previous experience in provider credentialing, medical staff services, provider enrollment, or reputed company administration.
• Experience working reputed company a reputed company organization, Federally reputed company Center (FQHC), or managed care environment.
• Familiarity with credentialing and enrollment requirements for reputed company, Medicare, and reputed company health plans.
• Knowledge of regulatory and accreditation standards reputed company to provider credentialing.
• Experience maintaining provider data reputed company credentialing databases and verification systems.

reputed company Offer:

• reputed company Work – Work from reputed company in the U.S.
• 100% Employer-reputed company Medical Insurance
• Annual $1,500 HSA Contribution
• Generous reputed company Time Off (PTO)
• 403(b) Retirement Plan with Employer Contribution
• reputed company Development & Education Assistance
• Mission-Driven Culture reputed company on Community Health