Credentialing Specialist

🔥 5 minutes ago

🇺🇸 United States – Remote

💵 $56k - $61k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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BerryDunn — Assurance, Tax and Consulting

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1974

🏥 Healthcare

🛡️ Insurance

⚖️ Legal

Healthcare • Insurance • Legal

BerryDunn is an award-winning accounting and consulting firm with a 50-year history dedicated to providing exceptional services in assurance, tax, and consulting. The firm focuses on forming close partnerships with clients to deliver customized solutions that drive meaningful outcomes. Its expert teams work across various sectors, helping public and private entities optimize finances, reduce risks, and improve business processes with a commitment to client success.

📋 Description

• Complete credentialing and re-credentialing applications for physicians, ancillary providers, facilities, or groups with third-party payers and governmental programs, including Medicare and Medicaid • Perform Primary Source Verification services, including verification of licenses, malpractice, and work history • Perform Primary Source Verification file audits as requested • Complete, update, and maintain CAQH profiles for providers • Maintain the Credentialing database with payer identification numbers and effective dates • Partner with client liaisons and billing departments to update provider enrollment status • Contact payers to follow up on submitted applications • Respond to inquiries from physicians, staff, hospitals, and managed care companies • Communicate with providers or designees to obtain credentialing information and required documents • Regularly update clients on process and communicate delays • Inform Credentialing leadership of project status and help manage deliverables and deadlines • Accurately record billable and non-billable hours in time and attendance software

🎯 Requirements

• High school education required • Bachelor’s degree preferred • 2-3 years of relevant healthcare experience required, including specialized skills in Credentialing and/or Medical Billing • Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Staff Service Management (CPMSM) certification a plus • Ability to work independently and in a team setting • Exceptional organization and time management skills to manage priorities and deadlines • Effective verbal, interpersonal, and written skills • Strong attention to detail and quality • Proficiency with Microsoft Office suite (Word, Outlook, Teams) and Adobe; Excel preferred • Minimal travel, less than 10% per year

🏖️ Benefits

• Eligible employees have access to benefits supporting physical, mental, career, social, and financial well-being • Reasonable accommodation for the application, interview, and job performance process • Equal employment opportunity workplace • Learning, development, and well-being culture focus