Credentialing Specialist

Job Description

Job Description

We are looking for a dedicated Credentialing Specialist to join our team on a contract basis in Torrance, California. In this role, you will play a crucial part in managing credentialing processes for healthcare providers, ensuring compliance with Medicare and commercial insurance requirements. This is a fantastic opportunity for professionals with credentialing expertise who are eager to expand their skills into medical billing, as training in this area will be provided.

Responsibilities :

• Handle credentialing for multiple healthcare providers, ensuring compliance with Medicare and commercial insurance standards.
• Prepare and submit re-credentialing applications in a timely and accurate manner.
• Monitor and maintain up-to-date records of provider credentials and certifications.
• Collaborate with healthcare providers and insurance companies to resolve credentialing issues.
• Ensure compliance with regulatory requirements and organizational policies during credentialing.
• Assist in learning and performing medical billing tasks as part of the role.
• Provide regular updates and reports on credentialing statuses to the relevant stakeholders.
• Maintain detailed documentation and records for all credentialing activities.
• Support the team in improving credentialing processes for efficiency and accuracy.
• Respond promptly to inquiries related to credentialing and billing processes.
• Proven experience in credentialing, including provider and physician credentialing.
• Strong understanding of credentialing processes and re-credentialing applications.
• Excellent organizational skills and attention to detail.
• Ability to manage multiple tasks and meet deadlines effectively.
• Proficiency in handling Medicare and commercial insurance credentialing.
• Interest in expanding skills into medical billing, with training provided.
• Strong communication skills for interacting with providers and insurance representatives.
• Familiarity with healthcare compliance regulations and standards.