FQHC Credentialing Lead, Insurance & Compliance

Metro Community Health Center; Pittsburgh (Allegheny County); On-site; USD 45,000 - 65,000; Full time

Job summary

A health organization in Pittsburgh is seeking a highly organized and detail-oriented FQHC Insurance Credentialing Specialist to oversee the credentialing process for medical, mental health, and dental providers. This role involves ensuring compliance with insurance regulations, managing applications, and liaising with credentialing bodies. The ideal candidate has 3-5 years of experience in healthcare credentialing and excellent communication skills. This full-time position offers an opportunity to make a significant impact in a healthcare setting.

Qualifications

• Degree or certification in healthcare administration or related field preferred.
• Minimum of 3-5 years of provider credentialing experience, preferably in a healthcare setting.
• Certified Insurance Credentialing Specialist (CICS) or Certified Professional Medical Services Management (CPMSM) preferred but not required.

Responsibilities

• Manage and oversee the insurance credentialing and re-credentialing process for all providers.
• Ensure timely submission of applications with Medicare, Medicaid, and commercial insurance.
• Collaborate with Human Resources, Billing, and Compliance departments.

Skills

Attention to detail

Organizational skills

Verbal communication

Written communication

EHR proficiency

Education

Degree in healthcare administration or related field

3-5 years of provider credentialing experience

Tools

Credentialing software

Microsoft Office Suite

Job description

A health organization in Pittsburgh is seeking a highly organized and detail-oriented FQHC Insurance Credentialing Specialist to oversee the credentialing process for medical, mental health, and dental providers. This role involves ensuring compliance with insurance regulations, managing applications, and liaising with credentialing bodies. The ideal candidate has 3-5 years of experience in healthcare credentialing and excellent communication skills. This full-time position offers an opportunity to make a significant impact in a healthcare setting.