Provider Credentialing & Onboarding Specialist

The Center for GI Health; Fully; Vor Ort; CHF 70.000 - 110.000; Vollzeit

Zusammenfassung

The Center for GI Health is seeking a Credentialing Specialist to support provider enrollments, CAQH maintenance, and license reviews within the Revenue Cycle Management team. You will help with hospital privileging and credentialing applications, requiring strong organization and professional communication.

Ideal candidates will have 0–2 years in credentialing, a high school diploma, and attention to detail. HIPAA compliance and teamwork are essential in this role.

Qualifikationen

• 0-2 years’ experience in managed care credentialing, billing and/or Medical Staff service setting.
• High School Diploma or equivalent.
• Working knowledge of medical terminology, billing; insurance a plus.
• HIPAA compliance awareness

Aufgaben

• Collects provider credentials and updates internal and external databases.
• Reviews and streamlines processes and workflows for the on-boarding department, using automation where appropriate.
• Interacts with varied levels of management, physician office staff and physicians effectively to accomplish credentialing and various elements.
• Maintain up-to-date data for each provider in credentialing databases and online systems.
• Maintain accurate provider rosters for insurance companies.
• Track completion of CAQH and when re-attestations are due for each provider.
• Track expirables, such as medical licenses, DEA, CDS.
• Notify administration, billing, and operations of the effective dates for providers.
• Initial Hospital and Reappointment Applications.
• Maintains confidentiality of provider information

Kenntnisse

Detail-oriented

Organized

Team player

Project coordination

Tenacity

Analytical

Self-starter

Ausbildung

High School Diploma or equivalent

Jobbeschreibung

The Center for GI Health is seeking a Credentialing Specialist to support provider enrollments, CAQH maintenance, and license reviews within the Revenue Cycle Management team. You will help with hospital privileging and credentialing applications, requiring strong organization and professional communication.

Ideal candidates will have 0–2 years in credentialing, a high school diploma, and attention to detail. HIPAA compliance and teamwork are essential in this role.