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)
Credentialing Specialist
PMC Medical Group is a privately owned, multi-specialty medical group with locations throughout New Hampshire, providing care and compassion to patients for over 30 years, in the areas of pain management, family medicine and management of substance use disorders.
Job description:
The Credentialing Specialist will manage and monitor provider and facility credentials and maintain accurate data with insurance carriers to ensure a regulatory compliance and accurate payment from payers. The credentialing specialist will work closely with lead team members in Operations, HR and Accounting to ensure staff qualifications remain up to date and payer contracts remain competitive. Credentialing specialist will also work closely with the billing department to resolve any discrepancies with carrier payments.
The Ideal Candidate will have:
Salary dependent upon education and past experience.
As a team member at PMC Medical Group, you’ll enjoy:
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0 Medical Staff Credentialing Specialist, Sr. jobs found in Portsmouth, NH area