Remote Credentialing Specialist (Healthcare)

Bazeta; Northern (KY); Hybrid; USD 56,000 - 63,000; Full time

Job summary

BerryDunn is seeking a Credentialing Specialist to join our Healthcare Compliance and Credentialing Practice Area. The role involves credentialing and re-credentialing for physicians and facilities, CAQH maintenance, primary source verification, and loading provider data into our credentialing database.

This position is planned to be remote with minimal travel. Responsibilities include processing applications, PSV, enrollment updates with payers, and client/provider communications to ensure

Qualifications

• 2-3 years of relevant healthcare experience.
• CPCS or CPMSM certification a plus.
• Proficiency with Microsoft Office suite (Word, Outlook, Teams) and Adobe; Excel preferred.
• Ability to work independently and in a team.

Responsibilities

• Complete credentialing and/or re-credentialing applications for physicians, ancillary providers and facilities or groups with third-party payers and governmental programs.
• Perform Primary Source Verification (PSV) services including licenses, malpractice and work history; conduct PSV file audits.
• Complete, update and maintain CAQH profiles for providers.
• Maintain a Credentialing database per BerryDunn policies for participating and non-participating providers.
• Partner with client liaisons to update enrollment status of providers.
• Contact payers to follow up on submitted applications within BerryDunn policies.
• Respond to inquiries from physicians, staff, hospitals, and managed care companies timely and professionally.
• Communicate with providers to obtain requisite credentialing information for timely submission of documents.
• Update clients regularly on process and delays.
• Account for hours (billable and non-billable) in time and attendance software for proper billing.

Skills

Healthcare experience

Credentialing experience

Teamwork

Education

High school diploma

Bachelor's degree preferred

CPCS certification

CPMSM certification

Tools

Microsoft Word

Microsoft Outlook

Microsoft Teams

Adobe

Excel

Job description

BerryDunn is seeking a Credentialing Specialist to join our Healthcare Compliance and Credentialing Practice Area. The role involves credentialing and re-credentialing for physicians and facilities, CAQH maintenance, primary source verification, and loading provider data into our credentialing database.

This position is planned to be remote with minimal travel. Responsibilities include processing applications, PSV, enrollment updates with payers, and client/provider communications to ensure