Clinical Credentialing & Privileging Specialist

Self Regional Healthcare; Greenwood (SC); On-site; USD 42,000 - 62,000; Full time

Job summary

Self Regional Healthcare in Greenwood, SC seeks an administrative professional to assist in the credentialing and privileging process for physicians and licensed independent providers. You will verify licensure, certifications, and insurance certificates before expiration and maintain data in the credentialing database.

Responsibilities include health surveillance per policy, data entry for each applicant, responding to verification requests, and maintaining files.

Qualifications

• Associates degree preferred or 3–5 years’ experience, preferably in healthcare.
• Strong interpersonal, computer, and telephone skills.
• Must be organized, detail oriented, and able to set priorities.
• Ability to prepare reports, maintain confidentiality, and collaborate with multiple departments.

Responsibilities

• Assist in credentialing and privileging for physicians and licensed independent providers.
• Obtain licensure, certification, and insurance certificates and verify before expiration.
• Maintain information in the credentialing database and respond to verification requests.
• Enter accurate data for each applicant and monitor health surveillance as required.
• Query NPDB, OIG exclusions, and SC State Medical Board as part of appointments.
• Maintain the Referring provider database and scan files per policy.
• Attend staff meetings and perform other duties as requested.

Skills

Interpersonal skills

Computer skills

Telephone communication

Detail oriented

Education

Associates degree preferred

Job description

Self Regional Healthcare in Greenwood, SC seeks an administrative professional to assist in the credentialing and privileging process for physicians and licensed independent providers. You will verify licensure, certifications, and insurance certificates before expiration and maintain data in the credentialing database.

Responsibilities include health surveillance per policy, data entry for each applicant, responding to verification requests, and maintaining files.