Credentialing Specialist

Essen Medical Associates; New York (NY); On-site; USD 30,307 - 34,440; Part time

Job summary

Essen Medical Associates is seeking a Credentialing Specialist to assist with administrative functions of the Credentialing Department. Essential responsibilities include reviewing applications, performing verification of credentials, and ensuring proper document maintenance.

The ideal candidate should possess excellent organizational and communication skills, with a Bachelor's degree in a health-related field and at least six months of relevant experience. The position offers a pay range of $22.00 to $25.00 per hour.

Qualifications

• Minimum six months of clerical support or medical credentialing assistance.
• Ability to communicate confidential information.
• Knowledge of credentialing procedures and standards.

Responsibilities

• Review credentialing application and log missing documentation.
• Perform primary source verification of credentials.
• Coordinate with staff to obtain required information from provider.

Skills

Organizational skills

Communication skills

Time-management skills

Interpersonal skills

Analytical skills

Education

Bachelor’s Degree in a Health-Related Discipline

High School Diploma

Tools

MS Office (Outlook, Word, Excel, PowerPoint, Access)

Job description

Job Summary

Job Summary: The Credentialing Specialist is responsible to coordinate and assist with the day-to-day administrative functions of the Department. The selected candidate will have excellent written communication skills, be able to multitask and manage time effectively and provide administrative support to the Delegation team within the Credentialing Department.

Responsibilities

• Review credentialing application for completeness and log any missing documentation
• Critically evaluate application for any issues that may require special consideration or additional review, and take appropriate action to resolve issue
• Perform primary source verification of credentials
• Notify Supervisor and Associate Director of any red flags, in a timely manner
• Coordinate with appropriate credentialing onboarding staff to obtain required information from provider
• Prepare payment requests for required verification fees
• Participate in the timely preparation of files for the monthly Credentialing Committee meetings, Delegated Credentialing audits, on-site audits and desktop audits
• Perform self-audits to ensure data integrity of provider files
• Implement proper maintenance of files (digital and hard copies)
• Complete other tasks or projects as assigned
• Provide back-up to other Credentialing staff as necessary

Qualifications

• Bachelor’s Degree in a Health-Related Discipline: Public Health, Healthcare Administrative, Health Service, Psychology or Sociology Highly Preferred
• High School Diploma Required
• Minimum of at least six months in a healthcare setting: providing clerical support or medical credentialing assistance. Preferably 1-2 years of relevant office / credentialing experience.
• Superior interpersonal skills to effectively interact with various levels of group practice leadership, as well as health care providers.
• Ability to communicate and process highly confidential information and exercise proper judgment and discretion in performing duties.
• Exceptional organizational, analytical and written and verbal communication skills.
• Proficient with MS Office (outlook, word, excel, power point, access)
• Excellent time-management skills.
• Knowledge of practitioner credentialing procedures and standards.
• Working knowledge of clinical operations and procedures.
• Informational research skills.

$22.00-$25.00 an hour

Equal Opportunity Employer

Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.