Credentialing Specialist (47605)

Charlotte Eye Ear Nose & Throat Associates, P.A. (CEENTA); Charlotte (NC); Hybrid; USD 45,000 - 60,000; Full time

Job summary

Charlotte Eye Ear Nose & Throat Associates, P.A. (CEENTA) is looking for a Credentialing Specialist in Charlotte, NC. You will be responsible for maintaining provider files, completing credentialing applications, and managing related data, all while ensuring compliance with necessary requirements.

This full-time position offers a supportive, mission-driven workplace focused on exceptional patient care. Candidates should possess a high school diploma, a minimum of 2 years of credentialing experience, and strong skills in MS Office.

Qualifications

• High school diploma or GED is required.
• Minimum of 2 years of credentialing experience is highly preferred.
• Strong MS Office skills are necessary.

Responsibilities

• Maintain individual provider files for credentialing applications.
• Complete credentialing applications for providers.
• Verify and maintain provider hospital privileges.

Skills

Credentialing experience

MS Office skills

Communication skills

Detail-oriented

Organizational skills

Education

High school diploma or GED

Tools

Credentialing systems

Job description

Credentialing Specialist

CEENTA is the premier eye, ear, nose, and throat group in the Carolinas. You'll join a supportive, mission-driven team committed to providing exceptional patient care, ethical healthcare practices, and a collaborative work environment.

What You Will Do

• Maintain individual provider files to include up-to-date information needed to complete the required governmental and commercial payer credentialing applications
• Maintain accurate provider profiles on CAQH, NPPES and CMS databases
• Complete credentialing applications to add providers to commercial payers, CMS and Medicaid
• Complete re-credentialing requests issued by government and commercial payers
• Verify and maintain provider hospital privileges within CredentialStream
• Ensure all individual provider locations within the practitioner database match the CEENTA location reports
• Work closely with the Business Office to identify and resolve any denials or authorization issues related to credentialing
• Maintain the provider flu and PPD grids and forward to appropriate staff
• Update and/or provide verification of all payer directories via electronic submission, email (spreadsheets) and/or phone
• Provide profile updates/verifications for active and termed CEENTA providers to various facilities
• Maintain internal tracking tools
• Submit reports and respond to inquiries

A Typical Day

You'll spend most of your day managing credentialing data, completing applications, updating provider records, and responding to inquiries.

Schedule

Full-time, Remote/hybrid scheduled hours typically fall Monday-Friday, 8:00 a.m. - 5:00 p.m.

Qualifications

• High school diploma or GED, required
• Minimum of 2 years credentialing experience, highly preferred
• NAMSS CPSC certification (preferred but not required)
• Experience with credentialing systems
• Strong MS Office skills
• Detail-oriented and organized
• Strong communication skills