Medical Staff Credentialing Specialist, Sr. jobs in Gainesville, FL

Description

We are currently seeking a Credentialing Specialist who is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages.

Responsibilities and Duties:

• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing and re-credentialing applications.
• Compiles and maintains current and accurate data for all providers.
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
• Maintains corporate provider contract files.
• Ensures practice addresses are current with health plans and contracts as needed.
• Applying for in-network contract with various insurance carriers.
• Maintains confidentiality, security, and physical safety of any Provider, Plan, and PHI data.
• Credential new providers and re-credential current providers with hospitals at which they hold staff privileges.

Requirements

Required/Preferred Qualifications:

• 1 year credentialing experience preferred.
• High school diploma/equivalent.
• Healthcare Credentialing experience is a plus.
• Must possess a strong proficiency with Microsoft Office Suite (Word/Excel/Outlook/PowerPoint).
• Medical Terminology.
• Must have knowledge with Credentialing databases such as MD Staff.
• Strong knowledge of Medical Contracts and negotiating.
• Versatile, flexible, and willing to work within a dynamic environment.
• Candidate must pass a background check.
• Medicaid, Medicare, CAQH, and Availity knowledge is a plus.

Schedule

This position reports to the Business Office Director. The schedule is M-F, 8:30AM-5PM.

Apply today

Apply on pedimhealthcare.com, click on Our People, click on Careers

Or send resume and cover letter to Emily Rizzo, HR Manager, at HR@pedimhealthcare.com

PM20

EOE