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Provider Credentialing Specialist I (Remote)
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Job Description
- Req#: 21290
Employer Industry: Health Insurance
Why consider this job opportunity:
- Salary up to $70,620
- Comprehensive benefits package, including various incentive programs and 401(k) contributions
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on provider experiences and data accuracy
What to Expect (Job Responsibilities):
- Analyze credentialing applications and perform primary source verification of credentials for network participation
- Respond to inquiries regarding provider participation eligibility, credentialing, and contractual status
- Maintain the provider file and electronic provider files with updated information during various processes
- Identify and resolve issues related to provider files, ensuring compliance with applicable laws and guidelines
- Prepare written responses and communicate effectively to obtain missing information
What is Required (Qualifications):
- Minimum educational requirement: High School Diploma or GED
- 3 years of physician credentialing experience or relevant health insurance/managed care operations experience
- Proficiency in Excel spreadsheets and understanding of Pivot tables
- Excellent verbal and written communication and interpersonal skills
- Knowledge of medical terminology and ability to follow standard operating procedures
How to Stand Out (Preferred Qualifications):
- Bachelor's Degree in Business, Healthcare Administration, or a related field
- Certified Provider Credentialing Specialist (CPCS) certification
#HealthInsurance #Credentialing #CareerOpportunity #CompetitivePay #HealthcareAdministration
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