Credentialing Specialist
On-sitePhoenix, Arizona, United States
Job Summary
Review and complete hospital and payor applications for all health care providers, including verification forms and letters for outside facilities. Maintain billing insurance grids, provider insurance grids, and individual physician spreadsheets by tracking licensure, certification, and CME credits. Organize daily work assignments and manage multiple provider files while ensuring all renewal applications are current. Assist the Credentialing Supervisor with job responsibilities as needed. This role supports a vertically integrated musculoskeletal outcomes management company across Arizona, Michigan, and Florida, requiring effective communication with physicians, licensing agencies, and insurance payors.
Required Qualifications
- 3-4 years of recent Credentialing experience
- Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers
- Knowledge of the credentialing process
- Knowledge of computer systems
- Knowledge of credentialing paperwork and timelines
- Knowledge of credentialing timelines and regulations
- Skill in establishing good working relationships with internal and external customers
- Skill in organizing daily work assignments for various providers
- Skill in managing multiple work assignments and set priorities
- Ability to establish good working relationships with internal and external customers
- Ability to communicate effectively with physicians, credentialing agencies and staff
- Ability to be organized and efficient in daily work activities/projects
- Some travel within community
- Requires sitting and standing associated with a normal office environment
- Some bending and stretching required
- Manual dexterity using a calculator and computer keyboard
Desired Qualifications
- High school diploma/GED or equivalent working knowledge preferred
- Some knowledge of insurance billing and hospital credentialing a plus
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.