Credentialing Specialist

Job not on LinkedIn

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Core Health LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🌍 Social Impact

Healthcare • Healthcare Insurance • Social Impact

Core Health LLC is a Health Services Management company specializing in managing at-risk patients, including the elderly, disabled, and those eligible for Medicaid and Medicare-Medicaid programs. The company collaborates with integrated health systems, Medicare Advantage Plans, and Accountable Care Organizations to enhance patient care in their communities. They also operate Health Alliance Connect, an integrated care program focused on seniors and individuals with disabilities.

📋 Description

• Partner with medical providers, hospitals, insurance companies, operations leaders, and other stakeholders to ensure providers are credentialed • Manage hospital and financial credentialing processes for new hires and existing providers • Handle credentialing documentation, communication, monitoring, and compliance with credentialing specifications • Stay abreast of credentialing and recredentialing requirements for each client group • Request, review, and verify credentialing applications and supporting documentation • Establish and maintain databases of provider details and credentialing data • Monitor provider license and certification expirations and ensure timely renewals • Notify providers and administration of upcoming expirations and documentation requests • Collaborate with hospitals, insurance companies, and other stakeholders to provide information and track credentialing progress • Provide status updates to operations leaders, providers, and other stakeholders • Resolve issues and escalate when appropriate • Perform other duties as assigned

🎯 Requirements

• High School Diploma or GED required • Prior administrative experience in a healthcare environment • Medical credentialing experience preferred • Experience with MS Outlook, Word, and Excel • Experience with MS Teams and credentialing software preferred • Knowledge of credentialing requirements and workflows for providers across differing client groups • Familiarity with healthcare jargon and credentialing terminology • Proficiency in Microsoft Office and credentialing-related software • Excellent verbal and written communication skills • Excellent interpersonal and customer service skills • Excellent organizational skills and attention to detail • Ability to work independently and exercise judgment in decision-making and issue resolution • Ability to navigate competing priorities and work effectively in a fast-paced environment • Ability to manage information flow in a timely and accurate manner • Ability to collaborate with professionals across various client groups and geographic locations • Ability to identify and execute opportunities for improvement • Growth mindset and team-oriented behaviors

🏖️ Benefits

• Equal opportunity employer • Drug-free workplace • ADA compliance as applicable