
Healthcare Credentialing Specialist
2 days ago
We are seeking a skilled Credentialing Specialist to join our team. The ideal candidate will have a strong understanding of Medicare/Medicaid processes, CAQH, and commercial payers. This role involves handling provider credentialing with Medicare, Medicaid, commercial insurance payers, and hospitals.
The successful candidate will oversee the full Medicare enrollment process, ensuring compliance with CMS guidelines. They will verify provider credentials and maintain accurate and up-to-date records. Additionally, they will monitor compliance with Medicare regulations and address any policy updates. The ability to manage multiple tasks and meet deadlines in a fast-paced environment is essential for this role.
Main Responsibilities:
- Oversee the full Medicare enrollment process, ensuring compliance with CMS guidelines.
- Verify provider credentials and maintain accurate and up-to-date records.
- Monitor compliance with Medicare regulations and address any policy updates.
- Complete and submit CMS-855I, 855B, and 855R applications as appropriate.
- Ensure 100% accuracy in application submissions to avoid delays.
Qualifications:
- Bachelor's degree in Healthcare Administration, Business, or related field preferred.
- At least 1-2 years of experience in credentialing, enrollment, or healthcare administration.
- Familiarity with Medicare/Medicaid processes, CAQH, and commercial payers.
- Strong knowledge of regulatory and compliance standards in healthcare.
- Proficient in MS Office Suite and experience with credentialing software or portals.
Benefits:
This is a full-time position requiring night shifts aligned with U.S. Central Time (7 PM – 4 AM). The successful candidate will be responsible for managing the end-to-end credentialing and enrollment processes for providers specializing in psychiatry and behavioral health services under the U.S. healthcare system.
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