
Credentialing Operations Coordinator
1 week ago
We are seeking an experienced Credentials Specialist to join our team in the medical billing sector.
Key Responsibilities:- Verify provider credentials, including education, training, licensure, and certification.
- Enroll providers with payers, including Medicare, Medicaid, and commercial insurance companies.
- Prepare and submit credentialing and enrollment applications to payers.
- Follow up with payers to resolve any issues or discrepancies related to credentialing and enrollment.
- Maintain accurate and up-to-date records of provider credentials and enrollment status.
- Ensure compliance with regulatory requirements, including HIPAA, OIG, and state-specific laws.
- Communicate with providers, payers, and internal stakeholders to resolve credentialing and enrollment issues.
- Accurately enter data into credentialing and billing systems.
- A high school diploma or equivalent is required; an associate's or bachelor's degree is preferred.
- Two years of experience in credentialing, medical billing, or a related field is required.
- Certified Provider Credentialing Specialist (CPCS) or Certified Credentialing Specialist (CCS) certification is preferred.
- Strong analytical, organizational, and communication skills are necessary.
- The ability to work in a fast-paced environment and meet deadlines is essential.
- Proficiency in Microsoft Office and credentialing software systems is required.
This is an entry-level, full-time position within the healthcare industry, specifically in outsourcing and consulting services.
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