CREDENTIALING SPECIALIST

Job Description

The Credentialing Specialist performs a wide variety of credentialing duties in support of RCM services. As an integral part of our RCM team, the position serves in a cross-functional, fast-paced environment in order to meet performance and quality assurance benchmarks. Essential duties include all aspects of credentialing for the various RCM clients nationwide and maintains an ongoing collaborative relationship with providers and insurance payers.

Responsibilities:
• Verify and maintain licensurecertification for all contracted providers.
• Verify and maintain provider information within company software
• Keep current on informational changes in nationwide credentialing procedures
• Auditing applications and licensure documentation for accuracy
• Communicate/answer questions regarding credentialing issues
• Understand current healthcare laws and regulations
• Minimum 2-3 years of relevant experience
• Excellent communication skills
• Ability to deal with a number of tasks simultaneously
• Strong attention to detail
• Intermediate computer skills to include Microsoft Word and Excel as well as database programs
• Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards
• Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services skills
• Must be highly flexible; able to accommodate changing needs of the department. Must be a self-starter, motivated and have the ability to multi-task


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