Medical Staff Credentialing Specialist, Sr. processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist, Sr. loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist, Sr. handles and resolves inquiries regarding credentialing information, process, or status. May provide guidance or expertise to less experienced specialists. Requires a high school diploma. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor. The Medical Staff Credentialing Specialist, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Medical Staff Credentialing Specialist, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Our Credentialing Support Specialist will be responsible to complete, submit and track credentialing data while demonstrating high attention to detail and accuracy with emphasis on timeliness. We are looking for a full-time specialist in our Lexington, South Carolina office.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
· Complies and maintains current and accurate data for assigned providers.
· Maintains credentialing and re-credentialing documents. To include health plan secure portal access and validate provider profiles/demographics.
· Prepares credentialing and licensing applications and gathers supporting documents.
· Develops and maintains spreadsheets for monitoring as directed.
· Maintains organizational notifications on a variety of managed care credentialing and licensing. To include relocations/openings/closures for organization.
· Maintains internal processes to ensure timely submission of credentialing/licensing packets to meet deadlines established by Managed Care Payors.
· Maintains internal processes to ensure that information is available to appropriate users.
· Assembles credentialing and re-credentialing packets in a neat and orderly fashion.
· Maintains a HIPAA compliant environment.
· Supports and maintains a positive team environment at all times.
· Exhibits exemplary customer service to both internal and external customers of the organization.
· Contributes to team effort by accomplishing related tasks as requested.
MINIMUM JOB REQUIREMENTS
· High school diploma or GED; at least 2 years of experience directly related to the duties and responsibilities specified.
· Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.
· Advanced computer knowledge, specifically as it relates to Microsoft Office (Word, Excel., etc.) Internet and Browsers required.
· Advanced data entry skills required.
· Excellent organizational skills required.
· Excellent oral and written communication skills required.
Job Type: Full-time
Pay: $13.00 - $16.00 per hour
Benefits:
Application Question(s):
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Ability to Relocate:
Work Location: On the road
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