Healthcare Credentialing Representative

Location: 100% work from home

• Responsible for providing administrative support for Provider Onboarding and Enrollment.
• This position is accountable for assigned functions of the Onboarding & Enrollment process to ensure that Providers meet the requirements for Credentialing and Employment in compliance with regulatory and healthcare requirements.
• Processes provider applications and re-applications including the submission, review, compliance, and ensures appropriate follow-up.

• Maintains up-to-date provider database system and communicates with providers regarding Onboarding and Credentialing requirements.
• Good knowledge and understanding of Credentialing and operating processes and procedures.
• Serves as a liaison between Providers and internal and external departments with regards to providing information in a timely manner.
• Works to clearly defined procedures under supervision.
• Special projects as assigned.

Skills:

• This person should be a detail-oriented, organized, decision-maker with the ability to work both independently and in teams.
• This person should understand basic technical concepts and explain them in simple terms in addition to identifying improvements and troubleshooting.

• Strong oral and written communication skills are also essential, as this role communicates with Providers, healthcare administrators, higher education institutions and government officials.
• This person should be knowledgeable in Medicare and Medicaid in states across the US, and knowledgeable of PECOS and the CAQH.

Non-Negotiable Skills:
• Customer service skills,
• Organizational skills, and strong communication skills

 Education:

• High School graduate with diploma or equivalent required
• Associates/Bachelor’s degree preferred or equivalent experience.
• 2 years of experience in Onboarding and Enrollment for Credentialing.