Credentialing Administrator
Credentialing Administrator
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
We are seeking a detailoriented and experienced Credentialing Administrator to join our dermatology practice. The Credentialing Administrator will be responsible for managing and maintaining the credentialing and recredentialing process for all healthcare providers ensuring compliance with regulatory and insurance requirements. The ideal candidate will have a strong understanding of credentialing procedures excellent organizational skills and the ability to communicate effectively with providers payers and internal staff.
Key Responsibilities:
- Oversee and manage the credentialing and recredentialing processes for physicians nurse practitioners and other healthcare providers within the practice.
- Maintain uptodate provider files ensuring all documentation is current and compliant with federal state and payerspecific requirements.
- Prepare and submit applications for provider enrollment with commercial and government insurance plans (Medicare Medicaid private insurers etc..
- Track and monitor the status of credentialing applications following up as needed to ensure timely approvals.
- Maintain credentialing databases and software updating records as necessary.
- Coordinate with providers and practice administrators to ensure timely submission of required documentation.
- Monitor and ensure compliance with regulatory bodies such as The Joint Commission (TJC) National Committee for Quality Assurance (NCQA) and the Centers for Medicare & Medicaid Services (CMS).
- Respond to inquiries regarding credentialing status and requirements.
- Assist in audits and provide reports on credentialing activities as needed.
Qualifications:
- Associates or Bachelors degree in healthcare administration business administration or a related field (preferred).
- Minimum of 23 years of experience in medical credentialing preferably in a Dermatology or multispecialty practice.
- Knowledge of provider enrollment procedures with Medicare and commercial payers.
- Familiarity with credentialing databases and software systems.
- Strong understanding of compliance regulations and industry standards.
- Excellent attention to detail and organizational skills.
- Strong communication and problemsolving abilities.
- Ability to work independently and manage multiple tasks efficiently.
Benefits:
- Competitive salary based on experience.
- Health dental and vision insurance.
- Paid time off and holidays.
- Professional development opportunities.
- Retirement plan options.
If you are a highly motivated professional with a passion for ensuring provider compliance and a commitment to excellence we invite you to apply for this position. Please submit your resume along with a cover letter.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
