Job Summary:
We are seeking a highly motivated and detailoriented Credentialing Specialist to join our team at RevGro MD. The successful candidate will be responsible for managing the credentialing and enrollment process for healthcare providers and facilities. This includes ensuring compliance with regulatory requirements maintaining accurate records and collaborating with various stakeholders to facilitate the smooth onboarding of healthcare professionals.
Responsibilities:
Credentialing and Enrollment: Manage the endtoend credentialing and enrollment process for healthcare providers and facilities.
Compliance: Ensure adherence to all relevant regulatory requirements and accreditation standards throughout the credentialing process.
Verification: Conduct thorough verification of professional credentials education training and other qualifications of healthcare professionals.
Application Processing: Review and process credentialing applications in a timely and accurate manner addressing any discrepancies or missing information.
Communication: Effectively communicate with healthcare providers insurance companies and internal teams to obtain necessary information and resolve credentialing issues.
Database Maintenance: Maintain accurate and uptodate credentialing databases and documentation for easy retrieval and reporting.
Quality Assurance: Implement and monitor quality assurance measures to uphold the highest standards in the credentialing process.
Collaboration: Collaborate with internal departments including billing and compliance to ensure seamless integration of credentialing activities with overall business operations.
Qualifications:
Bachelors degree in any field.
Minimum 1 to 2 years of experience in healthcare credentialing and enrollment.
Knowledge of relevant laws regulations and accreditation standards.
Strong attention to detail and organizational skills.
Excellent communication and interpersonal skills.
Ability to work independently and as part of a team.
Proficiency in using credentialing software and Microsoft Office applications.
Certification from a recognized credentialing organization is a plus.
Decent knowledge of portals like CAQH and PECOS is mandatory.
Benefits:
Competitive salary
Work from Home/Remote setup
Professional development opportunities
credentialing,healthcare,communication