
Medical Credentialing Expert
1 day ago
This role requires expertise in credentialing and re-credentialing of healthcare professionals. Ensuring accurate information is maintained on file and within the credentialing database is a key responsibility.
This position involves working independently with frequent coordination with team members.
Key Responsibilities:- Perform comprehensive credentialing for medical and behavioral providers, including contracting and CAQH attestation.
- Maintain confidentiality and discretion during communications related to credentialing applicants and applications.
- Develop effective communication skills to respond to emails and create insurance portals as required.
- Ensure knowledge of medical provider credentialing principles, policies, processes, procedures, and documentation.
- Proven experience as a Medical Biller in a US healthcare setting or similar role, requiring 2-3 years of experience.
- Proficiency in medical billing software and electronic health records (EHR/EMR) systems.
- In-depth knowledge of medical terminology, coding (CPT, ICD-10, HCPCS), and insurance billing procedures.
- Strong understanding of healthcare compliance and privacy regulations (HIPAA).
- Excellent communication skills for interacting professionally with patients, insurance companies, and healthcare providers.
- Outstanding organizational and time management skills for multitasking and prioritizing tasks effectively.
- Prior experience in credentialing is highly valued.
- Strong verbal and written communication skills are essential.
- Bachelor's degree in business administration or a related field is preferred.
As a Credentialing Specialist, you will contribute to ensuring the accuracy and validity of healthcare professional credentials. If you have a strong background in medical billing and credentialing, this role may be suitable for you.
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