Credentialing specialist [h1.location_city]

The Credentialing Specialist is responsible for all aspects of the credentialing and payer enrollment process for all providers and facilities. They are responsible for ensuring providers and facilities are credentialed, and enrolled in accordance with established accreditation, regulatory and policy requirements. Maintain up-to-date data for each provider and facility in credentialing database and online systems.

Essential Duties and Responsibilities :

• Compiles and maintains current and accurate data for all providers using the credentialing software.
• Completes provider and facility payer enrollment applications; monitors applications to ensure timely start dates and no lapses in enrollment.
• Maintains copies and tracks current state licenses, DEA certificates, health history, malpractice coverage and any other required credentialing documents for all providers and facilities.
• Maintains knowledge of current accreditation, regulatory and policy requirements.
• Other duties or projects as assigned.

Required Experience :

Knowledge and Skills :

Education / Licensing / Certification :