Credentialing Specialist GS9102

Typically, Monday - Friday, 8 hour shifts

About this Position

This role will work closely with the Clinic Outreach and Credentialing Administrator with the aim of credentialing of new providers and renewals for existing providers with Governmental insurers – Medicaid & the 3 MCO’s.

Position will also work with clinic administrators and the Clinic Outreach and Credentialing Administrator to support the needs of clinics for renewals.

The Credentialing Specialist will also work with department leadership in helping to address credentialing needs, respond to physicians, staff and supervisors.

Update SSI and Availity with the new provider and clinics information.

Work closely with the 3 MCO’s and submit them weekly rosters.

Work with the NPI registry for all termed and new physicians and groups.

Other duties as assigned.

Must be a team player.

• High School/GED (degree must be conferred on or before agreed upon start date)
• Minimum of three (3) years of experience in multi-specialty-provider credentialing encompassing government, and other Medicaid insurance products, with increasing responsibility during that time period, or related experience.

• Credentialing Specialist (CPCS) Certification or equivalent experience

• Must possess strong analytical skills. Excellent communication and organizational skills required.
• Ability to work independently, manage multiple priorities, and meet established deadlines.
• Leadership, communication, customer service, multi-tasking, and computer skills are necessary for this position.
• Experience dealing with clinical staff as well as financial support staff required.
• Must be a team player.

• Associate's
• Prefer six (6) years of experience in multi-specialty provider credentialing encompassing government, commercial and other insurance products.