Senior Process Associate Credentialing Specialist

As a Credentialing Specialist, you will be responsible for screening practitioner applications and verifying supporting documents. Your key tasks will include identifying discrepancies and following up with providers, handling Medicare and Medicaid enrollments and revalidations, and processing initial and re-credentialing applications with necessary follow-ups. Additionally, you will be tasked with creating and maintaining CAQH, PECOS, and NPPES profiles, as well as managing hospital privileges for both initial appointments and reappointments. Your role will also involve responding to credentialing inquiries from internal teams, participating in leadership meetings, and tracking credentialing status. Furthermore, you will provide assistance with contract negotiations. To excel in this role, you must possess a minimum of 13 years of DME credentialing experience, which is mandatory for this position. Additionally, a basic knowledge of the entire Revenue Cycle Management (RCM) process is required. Strong analytical and problem-solving skills are essential, along with prior experience in handling denials and insurance processing. Proficiency in English communication, both written and verbal, is crucial for effective interaction with various stakeholders.,