Remote Healthcare Credentialing Specialist

Point32Health, Inc.; United States; Sur place; USD 33 000 - 50 000; Plein temps

Résumé du poste

Point32Health, Inc. is seeking a Credentialing Specialist to ensure physicians and independent practitioners meet policy and regulatory requirements for participation in our health plans.

You will manage credentialing applications, verify credentials, and review NPDB and sanctions information, while collaborating with the Credentialing Compliance Coordinator and Medical Directors to keep files current and compliant.

Qualifications

• High school diploma required; bachelor’s degree preferred.
• 1–2 years of healthcare experience; credentialing experience preferred.
• Proficient in Word and Excel; strong written and verbal communication.

Responsabilités

• Maintain and process physician/provider credentialing information per policies and regulations.
• Enter credentialing applications into the Cactus system accurately and timely.
• Verify licenses, board certifications, and other credentials.
• Review adverse information from NPDB and state/federal sanctions.
• Prepare credentialing files for review by Credentialing Supervisor and Medical Directors.
• Identify issues requiring escalation to Medical Director or outside sources.
• Support daily file reviews and participation in related committees.
• Contribute to task forces and other initiatives as needed.

Connaissances

Credentialing

Attention to detail

Communication

Time management

MS Office

Formation

High school diploma

Bachelor’s degree

Outils

Cactus system

Description du poste

Point32Health, Inc. is seeking a Credentialing Specialist to ensure physicians and independent practitioners meet policy and regulatory requirements for participation in our health plans.

You will manage credentialing applications, verify credentials, and review NPDB and sanctions information, while collaborating with the Credentialing Compliance Coordinator and Medical Directors to keep files current and compliant.