Medical Credentialing Specialist
Job Title: Medical Credentialing Specialist
The Credentialing Specialist is responsible for credentialing individual, facility and/or ancillary medical/surgical providers to ensure all credentialing standards and internal requirements are met and maintained. Corresponds with licensing board, hospitals, certification agencies, training programs and medical groups, practitioners, office staff, provider network administrators, contracting and management to resolve issues. May review and identify credentialing or re-credentialing practitioners, including verification’s of correspondence, data entry, etc., in accordance with company policies and procedures.
High School Diploma/GED • Experience in healthcare related position/Customer Service, 2+ years credentialing experience/insurance verification
Associates degree in Business Administration, Health Care Administration or related field preferred
Good communication and interpersonal skills. • Organization skills and ability to be detail-oriented and accurate in work produced. • Skills with MS Office, i.e. Word, Excel, and/or PowerPoint.
Additional Desired Qualifications:
Leadership experience/ability/aptitude • Certification from National Association of Medical Staff Services (NAMSS) as a Certified Provider Credentialing Specialist (CPCS)