Provider Credentialing & Onboarding Specialist

101 Riverside Hospital, Inc.; United States; On-site; USD 29,000 - 38,000; Full time

Job summary

Riverside Health System seeks a credentialing specialist to manage provider applications, onboarding and credentialing activities for Riverside Medical Group. You will ensure data accuracy across multiple databases and assist with timely payor-related processes.

The role requires 2 years of credentialing experience, proficiency with iCare/EPIC, and familiarity with CMS regulations. CPCS preferred; high school diploma or GED required.

Qualifications

• 2 years active experience in credentialing/privileging (Required) in iCare/EPIC (Required).
• High School Diploma or GED (Required).
• Certified Provider Credentialing Specialist (CPCS) (Preferred).

Responsibilities

• Accurately complete and maintain Provider applications (Initial and Re-credentialing/Renewals) as required.
• Ensure timely Provider Onboarding to mitigate access issues for patients and drive financial growth.
• Release pending claims for newly credentialed providers to ensure financial stability for the Medical Group.
• Build and maintain provider information in Credentialing Database, CAQH, Echo, NPI, EMR/HER and patient accounting system.
• Maintain accurate information in internal and external directories per CMS and regulatory guidelines.
• Investigate problems related to credentialing, including payor status and denials, respond within 2 business days.
• Research licensure sanctions to ensure compliance with Federal and State regulations.

Skills

Credentialing/privileging experience

Education

High School Diploma or GED

CPCS (Preferred)

Tools

iCare/EPIC

CAQH

EMR/HER

NPI

Job description

Riverside Health System seeks a credentialing specialist to manage provider applications, onboarding and credentialing activities for Riverside Medical Group. You will ensure data accuracy across multiple databases and assist with timely payor-related processes.

The role requires 2 years of credentialing experience, proficiency with iCare/EPIC, and familiarity with CMS regulations. CPCS preferred; high school diploma or GED required.