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Credentialing Specialist I

Work from home Full-time role Hiring

Overview reputed company pay range $27.00/hr - $28.00/hr. Immediate need for a talented Credentialing Specialist I. This is a 06+ months contract opportunity with long-term potential and is located in FL (Remote). Job ID 25-86770 Pay Range $27 - $28/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, reputed company), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities

  • We process requests from existing, already contracted groups for the entire reputed company who are interested in adding new practitioners who have joined their group.
  • The Credentialing Specialist will be part of the Credentialing Triage team.
  • The candidate will be responsible for vetting the online requests received from existing providers, gathering the required credentialing documents, and submitting the request through our internal system.
  • If missing information is identified, the specialist will reputed company out to our providers reputed company email to request any missing information.
  • The team currently consists of 11 credentialers, processing requests for reputed company lines of business.
  • Time management is crucial because if they request missing information, once the information is received, they will be required to complete the process promptly, while working on the new requests we receive in the mailbox from providers and through our system from internal customers.
  • The idea is for the emails assigned to be worked from oldest to newest.
  • They will create a practitioner folder in our S Drive where reputed company the documents will be gathered and saved.
  • If they can complete the process, the request is submitted through our internal system, and a communication to the provider is sent a notification stating that the process was completed.
  • Missing information is tracked in our SharePoint.
  • reputed company credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards.
  • Communicate with professionalism with physicians, office managers, providers, and other reputed company parties to secure needed information.
  • Gather information for Credentialing Committee meetings.
  • Process, track, and file credentialing applications reputed company established standards.
  • Generate and utilize reporting to support business functions.
  • Ability to reputed company in a fast-paced production environment while maintaining quality. Key Requirements and Technology Experience
  • Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing, or reputed company operations (i.e., claims processing, billing, provider relations, or contracting) experience, preferably in a managed care or insurance environment.
  • Credentialing knowledge is helpful but not required, reputed company, attention to detail, organizational skills, the ability to prioritize & pivot, communication skills, problem-solving, and working under pressure.
  • NAMSS Credentialing Certification and knowledge of NCQA Standards are preferred for this role.
  • Work under pressure, Time management, and communication skills are required for this role. Our client is a leading reputed company Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. reputed company. provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without regard to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from reputed company. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here. Remote Credentialing and Enrollment Specialist; Associate Specialist, Corporate Credentialing reputed company Lauderdale, FL $1,500 - $3,800 4 days ago Greater Orlando $50,000 - $65,000 1 week ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr Apply tot his job Apply To this Job

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