Senior Credentialing & Compliance Specialist

Fresenius Medical Care; United States; Remote; USD 55,000 - 85,000; Full time

Job summary

Fresenius Medical Care is seeking a Sr. Credentialing Specialist to support onboarding providers by collecting and data entering credentialing information and documents.

You will monitor licensure, credentialing deadlines, and regulatory requirements while maintaining organized filing systems and collaborating with leadership. The role requires 2–4 years of related experience, strong organizational and communication skills, and a commitment to excellent customer service within a healthcare

Qualifications

• 2–4 years’ related experience.
• Strong organizational skills, with the ability to administer multiple tasks and prioritize.
• Excellent communication skills, written and oral, with the ability to communicate to all levels of personnel.
• Excellent customer service skills.
• Strong personal computer skills.
• Excellent organizational and analytical skills.

Responsibilities

• Serves as liaison to new onboarding providers to collect, save, and data enter all necessary credentialing information and documents.
• Provide weekly status updates to leadership on new onboarding providers.
• Provides information, support, and clarification to related staff and management regarding the regulatory requirements which pertain to continued participation in related health plan and networks.
• Monitors facility privileges expiration dates to ensure related staff completes re-credentialing applications in accordance with department procedure.
• Monitors Traditional Medicare and Traditional Medicaid re-validation due dates to ensure related staff completes re-validation applications in accordance with national and state government regulations.
• Provides support in resolving third party payor claim rejections for not-contracted.
• Researches and seeks to resolve the claim rejection. Obtains clarification from related parties such as payor when necessary.
• Leads team in the maintenance and updating of an organized credentialing and contracting filing database system.
• Monitors expiring/expired licenses and certificates.
• Purges files of expired and unnecessary documents and reports.
• Identifies and recommends techniques to improve workflows on an ongoing basis and to ensure compliance.
• Maintains a report of all applications and distributes to primary contacts, such as management and leadership team.
• Requests and/or develops reports required by payor
• Creates training tools for related staff, as needed
• Escalates issues to supervisor/manager for resolution, as deemed necessary.
• Builds productive working relationships.
• Other duties as assigned.

Skills

Organizational skills

Communication

Customer service

PC proficiency

Analytical skills

Education

High School Diploma

Associate’s Degree desirable

Job description

Fresenius Medical Care is seeking a Sr. Credentialing Specialist to support onboarding providers by collecting and data entering credentialing information and documents.

You will monitor licensure, credentialing deadlines, and regulatory requirements while maintaining organized filing systems and collaborating with leadership. The role requires 2–4 years of related experience, strong organizational and communication skills, and a commitment to excellent customer service within a healthcare