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Credentialing Specialist II
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Job Description
- Req#: JR-80483
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including Medical, Dental, and Vision plans
- Tuition assistance of $5,250/year and reimbursement for certifications
- Annual discretionary bonus potential based on eligibility criteria
- Supportive and inclusive work environment reflecting community diversity
- Flexible work options available in multiple states
What to Expect (Job Responsibilities):
- Process and manage credentialing and re-credentialing for medical and behavioral providers
- Conduct primary source verifications in compliance with regulations
- Review and investigate applications for accuracy and completeness
- Collaborate with the Credentialing Supervisor/Manager to meet deadlines
- Maintain thorough documentation and records for credentialing processes
What is Required (Qualifications):
- High School Diploma required
- Minimum of 2 years of experience in managed care provider credentialing/re-credentialing
- Knowledge of credentialing principles, methods, regulations, and procedures
- Experience with organizations such as 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 tools such as Excel
- Experience with Epic or other revenue cycle management systems
- Knowledge of accounts receivable and billing processes
- Demonstrated ability to handle provider enrollment denials and appeals
- Previous involvement in onboarding and credentialing processes
#HealthcareServices #Credentialing #CareerOpportunity #DiversityAndInclusion #FlexibleWork
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