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Credentialing Specialist I Provider Enrollment
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Job Description
- Req#: JR-83761
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits including Medical, Dental, and Vision plans
- Tuition Assistance up to $5,250/year and student debt pay down of $10,000
- Paid Time Off and Sick Leave, along with Paid Parental & Family Caregiver Leave
- Potential for an annual discretionary bonus based on eligibility criteria
- Supportive and inclusive work environment within a diverse workforce
What to Expect (Job Responsibilities):
- Ensure healthcare professionals and providers meet necessary qualifications and comply with regulatory standards
- Gather and verify a variety of documents and information for credentialing
- Coordinate with healthcare providers to maintain accurate credentialing files
- Maintain compliance with managed care provider credentialing principles and regulations
- Assist in onboarding processes and managing provider enrollment denials and appeals
What is Required (Qualifications):
- High School Diploma
- Minimum of 1 year of directly related experience in managed care provider credentialing
- Thorough knowledge of credentialing principles, methods, regulations, and procedures
- Experience with organizations such as a CVO, MCO, HMO, or Hospital Based Credentialing (MSO)
- CPCS - Certified Provider Credentialing Specialist (preferred)
How to Stand Out (Preferred Qualifications):
- Familiarity with data analysis and accounts receivable processes
- Experience using credentialing software such as Credential Stream or Epic
- Knowledge of revenue cycle management and billing practices
- Strong communication skills to effectively interact with healthcare providers
- Ability to work collaboratively in a team-oriented environment
#HealthcareServices #ProviderCredentialing #CareerOpportunity #DiversityAndInclusion #CompetitiveBenefits
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