Credentialing Specialist

As a Credentialing Specialist at Nao Medical, you will play a crucial role in managing the credentialing and recredentialing processes for healthcare providers. Your responsibilities will include ensuring that all necessary licenses, certifications, and documentation are in place for providers to deliver services in compliance with regulatory and contractual obligations. The ideal candidate for this position will possess experience in healthcare credentialing, a comprehensive understanding of healthcare regulations, and the ability to efficiently manage multiple tasks with precision. Your primary responsibilities will involve processing initial credentialing and recredentialing applications for healthcare providers in alignment with organizational policies and state/federal regulations. You will be tasked with verifying the credentials of healthcare providers, which includes assessing their education, certifications, licensure, and professional background. Additionally, you will accurately maintain provider information in the credentialing database, ensuring that all necessary documentation is up-to-date and complete. In your role, you will act as a liaison between providers, healthcare organizations, insurance companies such as Medicare and Medicaid, and regulatory agencies to address any credentialing issues that may arise. You will also be responsible for preparing and maintaining audit files for accreditation and regulatory surveys, as well as generating reports related to credentialing activities as requested by management. Furthermore, you will be expected to identify opportunities for enhancing the credentialing process by streamlining workflows and implementing best practices. To qualify for this position, candidates should ideally possess a Bachelor's degree in healthcare administration, business administration, or a related field, or have equivalent experience. A minimum of 2-3 years of experience in credentialing, medical staff services, or healthcare administration is required. Familiarity with insurance companies" policies (e.g., Medicare, Medicaid), healthcare credentialing processes, regulatory requirements, and compliance standards is also essential. In terms of technical requirements, candidates must provide their own equipment meeting specific specifications, including an up-to-date desktop or laptop computer with at least 8GB of RAM and a modern processor, operating on Windows 10 or macOS 10.15 (Catalina) or later. A high-speed internet connection with a minimum speed of 25 Mbps, a functional headset with microphone, webcam, and reliable keyboard and mouse, as well as a quiet workspace free of distractions, are necessary. A second monitor is preferred but not mandatory, and an emergency backup or contingency plan for technology or connectivity issues should be in place. Nao Medical is committed to fostering a work environment that is free from discrimination and harassment, where all individuals are treated with respect and dignity. Embracing diversity in backgrounds and experiences leads to a more innovative, creative, and productive workforce. Join us at Nao Medical and be part of our mission to transform healthcare!,