Delegated Credentialing Specialist II – Managed Care

Memorial Hospital at Gulfport; Biloxi (MS); On-site; USD 42,000 - 62,000; Full time

Job summary

Memorial Hospital at Gulfport seeks a Delegated Credentialing Specialist II for a day shift in a full-time capacity. You will ensure physicians and providers are credentialed with delegated plans, monitor compliance, and maintain accurate data across databases.

The role involves coordinating provider enrollments, audits, and onboarding activities. The position requires 2 years of credentialing experience, CPCS certification, and strong written and verbal communication.

Qualifications

• Requires an Associate degree in Business or healthcare field; experience may be accepted in lieu of degree requirement.
• Preferred: Bachelor's Degree in Business or Healthcare field.
• Certification: Certified Provider Credentialing Specialist (CPCS) is preferred/required.
• Experience: 2 years direct credentialing experience.
• Skills: Strong verbal and written communication, data entry accuracy, database management.

Responsibilities

• Compile and complete physician/provider credentialing forms for payor delegations.
• Coordinate enrollment applications and credentialing files with payors and providers.
• Maintain credentialing databases and track license/certification expirations.
• Assist with audits and post-audit resolutions with insurance representatives.
• Support provider onboarding by obtaining necessary information/signatures.

Education

Associates degree in Business or healthcare related field

Bachelor's Degree in Business or Healthcare related field

Job description

Memorial Hospital at Gulfport seeks a Delegated Credentialing Specialist II for a day shift in a full-time capacity. You will ensure physicians and providers are credentialed with delegated plans, monitor compliance, and maintain accurate data across databases.

The role involves coordinating provider enrollments, audits, and onboarding activities. The position requires 2 years of credentialing experience, CPCS certification, and strong written and verbal communication.