Role Description
Managing provider credentialing & re-credentialing, ensuring efficient operations and maintaining current staff data.
• Ensures healthcare professionals and services meet federal, state, and NCQA standards; verifies professional licensing, training, and certifications.
• Prepares and maintains reports of credentialing activities.
• Coordinates medical staff appointments, processes applications/licensing, and manages the provider credentialing process, facilitating communication across departments and administration.
• Ensures compliance with accreditation and legal requirements for medical staff.
• Contacts medical offices, licensing agencies, and insurance carriers to complete credentialing and re-credentialing.
• Tracks and reports credentialing performance measures.
Qualifications
• High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
• Required professional licensure/certification can be used in lieu of education or experience, if applicable.
Requirements
• Experienced in credentialing software (preferably MD Staff), ability to use Excel proficiently.
• Strong skill-sets to focus on details of data and enter accurately.
• Majority of day is utilizing software and inputting data.
• Must be able to focus on customer service when talking to credentialed practitioners on phone.
• 3+ years of experience.
Benefits
• Paid time off (PTO)
• Various health insurance options & wellness plans
• Retirement benefits including employer match plans
• Long-term & short-term disability
• Employee assistance programs (EAP)
• Parental leave & adoption assistance
• Tuition reimbursement
• Ways to give back to your community