Medical Credentialing Specialist bei undefined
undefined · Fort Myers, Vereinigte Staaten Von Amerika · Remote
- Professional
We are seeking a full-time Credentialing Coordinator/Specialist to manage the credentialing and re-credentialing process for 132 providers across 12 facilities. This role is critical in ensuring compliance with regulatory standards, payer requirements, and organizational policies. The Credentialing Coordinator/Specialist will maintain organized workflows, verify provider credentials, and collaborate with key stakeholders to uphold high-quality care standards across all facilities.
Key Responsibilities:
- Manage credentialing and re-credentialing for 132 providers across 12 facilities, ensuring timely submissions and updates.
- Verify and process provider credentials, including licensure, certifications, education, and work history.
- Maintain accurate and up-to-date records in credentialing databases and software.
- Coordinate with providers, payers, and facility administrators to resolve discrepancies or delays.
- Ensure compliance with all applicable federal, state, and organizational regulations.
- Prepare and submit applications for payer enrollment, hospital privileges, and re-credentialing as needed.
- Collaborate with cross-functional teams to support operational and regulatory goals.
- Monitor expiring credentials and notify providers of renewal deadlines.
- Generate reports to track credentialing progress and meet organizational objectives.
Qualifications:
- High school diploma or equivalent required; Associate's or Bachelor's degree in healthcare administration or related field preferred.
- Minimum of 2 years of credentialing experience in a healthcare setting.
- Knowledge of NCQA, JCAHO, and CMS standards.
- Familiarity with payer enrollment processes.
- Proficient in Microsoft Office Suite and credentialing software (e.g., CAQH, MD-Staff).
- Exceptional organizational skills and attention to detail.
- Strong communication and problem-solving abilities.
- Ability to work independently and meet tight deadlines.
Preferred Qualifications:
- Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM).
- Experience managing credentialing for multiple providers and facilities.
Why Join HCCS?
- Competitive salary and benefits package.
- Opportunity to work with a collaborative and supportive team.
- Professional growth and development opportunities.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Experience:
- Microsoft Office: 2 years (Required)
- Credentialing: 2 years (Required)
Location:
- United States (Required)
Work Location: Remote