Company Overview
Major Health Care organization located on Long Island seeks experienced Credentialing Specialist for processing and re-credentialing applications for healthcare providers and facilities. Individual will complete applications, verify information and input information into a database. The on-site position requires excellent verbal skills as you will be contacting medical staff, licensing agencies and insurance companies for the information and verification.
Responsibilities
- Manage initial credentialing and re-credentialing for facilities, radiologists, physical therapists, and other clinical providers.
- Complete and maintain provider enrollments with Medicare, Medicaid, and other insurance payers.
- Maintain and update provider information in credentialing systems.
- Track expiration dates for providers licenses, credentials, CAQH profiles and other portals as necessary.
- Monitor application status and proactively follow up with payers to ensure timely approvals.
- Maintain accurate credentialing and enrollment records.
- Support provider onboarding and network participation efforts.
- Ensure compliance with payer, state, federal, and accreditation requirements.
Qualifications
- 3-5 years of healthcare credentialing and provider enrollment experience preferred.
- Experience credentialing radiology providers is a plus.
- Working knowledge of CAQH, NPI, PECOS, Medicare, Medicaid, and commercial payer enrollment processes and portals.
- Familiar with HealthStream (CredentialStream) Credentialing Software
Skills
- Knowledge of commonly-used terminology, concepts, practices, and procedures in a radiology practice
- Exceptional verbal and written communication skills
- Strong organizational and multi-tasking skills required.
- Must be detail oriented
- Must have the ability to work independently and as part of a team
Pay: $26.00 - $31.00 per hour
Benefits:
- 401(k)
- AD&D insurance
- Dental insurance
- Disability insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Parental leave
- Vision insurance
Work Location: In person
