Overview:
Responsible for managing credentialing and re-credentialing processes for healthcare providers, ensuring compliance with policies and standards.
Key Responsibilities:
- Credentialing: Process applications, verify credentials, and update provider information in the system.
- Data Management: Maintain accurate records in credentialing software and track verification responses.
- Application Review: Ensure completeness of applications and request missing documentation.
- Compliance: Adhere to organizational policies and accreditation standards.
- Communication: Act as a liaison between providers, entities, and departments.
Qualifications:
- Education: High school diploma (required); degree in healthcare administration (preferred).
- Experience: Credentialing or healthcare administration experience preferred.
- Skills: Attention to detail, strong organization, and effective communication.
- Certifications: certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred
