Credentialing Associate

Credentialing Associate

Job Summary

As a Credentialing Associate, you will be responsible for ensuring the accuracy and completeness of healthcare provider credentials. Your attention to detail, organizational skills, and ability to navigate complex processes will contribute to maintaining high standards of quality and compliance within our organization.

Responsibilities

• Credential Verification: Review and validate healthcare provider credentials, including medical licenses, board certifications, DEA registrations, and malpractice insurance.

• Data Entry: Enter and maintain accurate records in credentialing databases and systems.

• Provider Enrollment: Assist in the enrollment process with insurance panels, Medicare, Medicaid, and other payers

• Compliance: Ensure compliance with state, federal, and accrediting agency requirements related to credentialing.

• Communication: Collaborate with providers, hospitals, and other stakeholders to resolve credentialing issues.

• Process Support: Assist in managing the credentialing process from application submission to approval.

• Audits and Reporting: Participate in internal audits and generate reports as needed