Medical Credentialing Specialist
Our client is an industry leader in providing interventional services to long term care facilities and outpatient facilities through-out the New York Metro Area. They are seeking a Medical Credentialing Specialist to join their highly skilled team whose mission is to provide quality compassionate care to their patients.
- Facility credentialing including creating and maintaining relationships with facility staff and maintaining provider credentials with facility.
- Track submitted applications and follow up as needed.
- Ensure current copies of state licenses, malpractice coverage and any other required credentialing documents are up to date.
- Sets up accurate provider information in online credentialing database system
- Knowledge of current health plan and agency requirement for credentialing providers.
- Conduct license verification for all providers in accordance with license verification policy
- Monitor payer websites for relevant bulletins/policy changes for distribution to billing, authorization and other administrative personnel.
- Establish effective working relationships with providers, management, and staff
- High School Diploma or GED required.
- Bachelors Degree preferred.
- Billing experience and prior credentialing experience preferred.
- Experience working for a private medical practice and insurance companies
- Out of state credentialing experience
- Verbal and written communication.
- Attention to detail and organizational skills