We are seeking a credentialing candidate that is a highly motivated, autonomous individual who has a positive attitude to join our company as a Credentialing Specialist on the Managed Care Operations team.
Qualified candidates must possess:
- Minimum of 3-5 years’ experience credentialing providers
- Health plan knowledge and familiarity required credentialing all payor types: Managed Care, Medicare & Medicaid Replacements & Workers Compensation
- Experience utilizing & maintaining credentialing database
- Highly knowledgeable & proficient with CAQH database. Familiarity with CAQH Practice Administrator role.
- Have established relationships with credentialing reps at various health plans
- Prepare and process credentialing applications for all payor types
- Experience credentialing multi-Tax ID entities
- Comfortable processing high volume credentialing applications & recredentialing applications
- Meet and adhere to company’s turnaround time and comply with credentialing goals and performance metrics
- Customer service oriented & easily able to develop relationships.
- Will have a detail-oriented and motivated work ethic, as well as capable of managing projects in a timely manner to meet set deadlines
- Possess excellent organizational, interpersonal, and communication skills
MS Word, Excel & Access skills required
