Credentialing Specialist

Job description

It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
Day Shift - 7.5 Hours (United States of America)
Job Responsibilities
• Coordinate and monitor the review and analysis of practitioner applications and supporting documentation to ensure eligibility and compliance.
• Conduct thorough background investigation, research and primary source verification of all components within credentialing/payer enrollment files.
• Identify credentialing and enrollment discrepancies that require additional investigation; facilitate appropriate follow-ups to resolve issues effectively.
• Prepare, track, and secure required practitioner signatures for enrollment files in a timely manner to avoid onboarding delays.
• Utilizes Symplr credentialing database to retrieve credentialing documents in accordance with the Health Care Quality Improvement Act.
• Collaborate with Richmond Health Network’s administration to ensure seamless information exchange during the practitioner on-boarding and off-boarding processes.
• Perform miscellaneous job-related duties and special projects as assigned.

Job Qualifications
• High school diploma or GED required.
• Proven experience in healthcare provider credentialing and payer enrollment.
• Minimum of 1 year of experience working within a physician billing or third-party payer environment.
• Strong, practitioner-focused communication skills with the ability to explain complex credentialing and enrollment processes clearly.
• Excellent organization, time management, and customer service skills.
• Absolute commitment to maintaining strict confidentiality regarding proprietary information and provider files.
• Proficient with data entry, MS Office Suite (Word, Excel, Outlook, PowerPoint), and Symplr credentialing software.
• Ability to thrive under tight deadlines and manage a high-volume workload efficiently.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!