Healthcare Credentialing & Enrollment Specialist

Richmond University Medical Center; New York (NY); On-site; USD 60,000 - 65,000; Full time

Job summary

Richmond University Medical Center is seeking a credentialing specialist to coordinate and monitor practitioner applications and supporting documentation, ensuring eligibility and compliance. The role includes conducting background investigations, primary source verification, and resolving discrepancies to prevent onboarding delays.

The candidate will retrieve documents via Symplr, collaborate with Richmond Health Network for onboarding/offboarding information exchange, and handle miscellaneous

Qualifications

• High school diploma or GED required.
• Minimum 1 year of experience in physician billing or third-party payer environment.
• Strong communication and ability to explain credentialing processes clearly.
• Proficient with MS Office and Symplr credentialing software.

Responsibilities

• Coordinate and monitor the review and analysis of practitioner applications and supporting documentation to ensure eligibility and compliance.
• Conduct thorough background investigation, research and primary source verification of all components within credentialing/payer enrollment files.
• Identify credentialing and enrollment discrepancies that require additional investigation; facilitate appropriate follow-ups to resolve issues effectively.
• Prepare, track, and secure required practitioner signatures for enrollment files in a timely manner to avoid onboarding delays.
• Utilizes Symplr credentialing database to retrieve credentialing documents in accordance with the Health Care Quality Improvement Act.
• Collaborate with Richmond Health Network’s administration to ensure seamless information exchange during the practitioner on-boarding and off-boarding processes.
• Perform miscellaneous job-related duties and special projects as assigned.

Skills

Communication skills

Organization

Data entry

Confidentiality

Education

High school diploma or GED

Tools

Symplr Credentialing

MS Office

Job description

Richmond University Medical Center is seeking a credentialing specialist to coordinate and monitor practitioner applications and supporting documentation, ensuring eligibility and compliance. The role includes conducting background investigations, primary source verification, and resolving discrepancies to prevent onboarding delays.

The candidate will retrieve documents via Symplr, collaborate with Richmond Health Network for onboarding/offboarding information exchange, and handle miscellaneous