Healthcare Credentialing Specialist: Verifications & Compliance

Oklahoma Mental Health Council; Oklahoma City (OK); On-site; USD 42,000 - 58,000; Full time

Benefits offered by this job

Health Insurance

Dental and Vision Insurance

Retirement Plan

Student Loan Repayment Options

Paid Time Off

9 Paid Holidays

Education Leave

Volunteer Leave

Bonuses Eligible

Job summary

Red Rock Behavioral Health Services seeks a Credentialing Specialist in Oklahoma City to ensure clinicians are credentialed with the Oklahoma Health Care Authority, Medicare, and private insurers. You will help maintain the credentialing database and keep electronic files up to date.

The position requires strong attention to detail, the ability to work independently under pressure, and knowledge of CARF and regulatory standards. Travel is limited.

Qualifications

• High School Diploma or equivalent; Associate degree preferred.
• Minimum one year of healthcare credentialing experience.
• Ability to maintain confidentiality and work independently under pressure.

Responsibilities

• Maintain credentialing processes for clinicians and build rapport with clinicians and insurers
• Enter/log/scan information into credentialing system for initial, updating, and maintenance
• Process credentialing and re-credentialing per policy and CARF/state/federal regulations
• Monitor information collection and follow up on missing items
• Identify red flags and document issues with clinicians and providers
• Notify Credentialing Supervisor of questionable information
• Maintain electronic credentialing files up to date
• Perform other duties as required

Skills

Credentialing experience

Healthcare industry knowledge

Attention to detail

Independent working

Education

High School Diploma or equivalent

Associates degree preferred

Tools

Credentialing software

Job description

Red Rock Behavioral Health Services seeks a Credentialing Specialist in Oklahoma City to ensure clinicians are credentialed with the Oklahoma Health Care Authority, Medicare, and private insurers. You will help maintain the credentialing database and keep electronic files up to date.

The position requires strong attention to detail, the ability to work independently under pressure, and knowledge of CARF and regulatory standards. Travel is limited.