Credentialing

Job Title: Credentialing [Nightshift]

Location

Job Summary:

The Credentialing Specialist will be responsible for overseeing the credentialing and recredentialing process for healthcare providers, ensuring that all necessary documentation is submitted, verified, and compliant with healthcare regulations and insurance company requirements. This role will involve close collaboration with the billing department, healthcare providers, insurance companies, and various stakeholders to ensure the timely and accurate processing of credentialing applications.

Key Responsible:

• Manage the credentialing and recredentialing process for healthcare providers,
• Ensuring timely documentation submission, compliance with regulatory requirements, verification of qualifications, coordination with insurance companies
• Collaboration with the billing team to resolve issues, track credentials, and support providers with the credentialing process while continuously improving procedures and staying updated on industry trends.

Desired Candidate Profile

• Bachelors degree.
• Preferably women candidates with a minimum of 6 months of experience in credentialing.
• Strong understanding of healthcare industry standards, payer requirements, and the credentialing process.
• Familiarity with credentialing software and/or healthcare management systems is highly desirable.
• Strong understanding of HIPAA compliance and privacy regulations.
• Excellent written and verbal communication skills.
• Exceptional attention to detail.
• Proficient in Microsoft Office Suite (Excel, Word) and credentialing management systems.