Credentialing Specialist

Essential Duties

• Stay abreast of credentialing and recredentialing requirements for each client group
• Requests, reviews, and verifies credentialing applications and supporting documentation
• Establish and maintain database of provider details and credentialing data
• Monitor license and certification expirations for providers to ensure timely renewals
• Notify providers and administration of upcoming expirations and documentation requests
• Collaborate with hospitals, insurance companies, and other stakeholders to extend information and track credentialing process
• Provide status updates to operations leaders, providers, and other stakeholders
• Resolve issues that arise and escalate when appropriate
• Other duties as assigned

Skills, Knowledge, Abilities

• Knowledgeable on credentialing requirements and workflows for providers at differing client groups
• Familiar with healthcare jargon and terminology related to credentialing
• Excellent verbal and written communication skills
• Excellent interpersonal and customer service skills
• Proficient in Microsoft Office and credentialing related software
• Excellent organizational skills and attention to detail
• Work independently and exercise judgement on decision making and issue resolution
• Navigate competing priorities and effectively work in a fast-paced environment
• Manage information flow in a timely and accurate manner
• Collaborate with an array of professionals at various client groups and geographic locations
• Identify and execute opportunities for improvement
• Exhibit growth mindset and team-orientated behaviors
• Core Clinical Partners is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
• Requirements

Education

Experience

Requirements

• Knowledgeable on credentialing requirements and workflows for providers at differing client groups
• Familiar with healthcare jargon and terminology related to credentialing
• Excellent verbal and written communication skills
• Excellent interpersonal and customer service skills
• Proficient in Microsoft Office and credentialing related software
• Excellent organizational skills and attention to detail
• Work independently and exercise judgement on decision making and issue resolution
• Navigate competing priorities and effectively work in a fast-paced environment
• Manage information flow in a timely and accurate manner
• Collaborate with an array of professionals at various client groups and geographic locations
• Identify and execute opportunities for improvement
• Exhibit growth mindset and team-orientated behaviors
• Core Clinical Partners is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
• Requirements