Top 8 Credentialing specialist Jobs in Pottstown, Pa

Credentialing Specialist
DERMATOLOGY MANAGEMENT PARTNERS LLC —Pottstown, PA
- No weekends
- Mid-level
- Organizational skills
- Commercial
- Paid holidays
- Disability insurance
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Payer Credentialing Specialist
Merakey —Lafayette Hill, PA
- From $20 an hour
- Remote
- Microsoft Outlook
- Computer literacy
- Research
- Health insurance
- Dental insurance
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Credentialing Specialist
Dermatology Management Partners LLC —Pottstown, PA
Experience with state Medicaid enrollment is preferred. Familiarity or experience with provider enrollment or medical licensing.
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Payer Credentialing Specialist
Merakey —Lafayette Hill, PA
On the Goga well-being platform, featuring self-care tools and resources. Strong knowledge of credentialing processes, including payer submissions, re-…
From $20 an hour
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Credentialing Specialist-(Day)FT
Adena Health System —Chillicothe, OH
Must possess a valid National Association Medical Staff Services (NAMSS) Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified…
14d
Provider Enrollment Specialist-Day(FT)
Adena Health System —Chillicothe, OH
Minimum Qualifications Required Educational Degree: High School Diploma or GED Major/Area of Concentration: Preferred Education: Associates Degree in Business…
8d

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Credentialing Specialist

DERMATOLOGY MANAGEMENT PARTNERS LLC
Pottstown, PA

Quick Apply

Job Details

Benefits

Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
401(k) 4% Match
Employee assistance program
Vision insurance
401(k) matching
Employee discount
Life insurance
Referral program

Qualifications

Provider enrollment for medical credentialing
Health insurance knowledge
Medicaid

Full Job Description

Join us at Dermatology Partners, where your career flourishes alongside your health and happiness. Your future starts here-let's grow together!

Discover the Benefits of Joining Dermatology Partners!

No Nights or Weekends
Growth Opportunity
Medical, Dental, and Vision Insurance
PTO & Paid Holiday’s
401 (k) with 4% employee match-Fully Vested from day 1
Company paid Life Insurance
Options of additional Life insurance, Short & Long term disability, Critical Illness and Accident Insurance
Employee Discount
Referral Bonus
Employee Appreciation Day: Dorney Park in Fall
Employee Assistance Program (EAP)

Dermatology Partners is a Dermatology group with locations in Pennsylvania, Delaware, and Maryland. Our Core values are the foundation for everything we do as an organization.

Our Core Values are:

Grow Together
Seize Opportunity from Struggle
Outcome Over Ego
Commitment to Serve
Do The Right Thing

Credentialing Specialist

The Credentialing Specialist position is responsible for ensuring that healthcare providers are properly credentialed and in compliance with all regulatory and organizational standards. This role involves verifying the credentials, licensures, certifications, and background of medical professionals to maintain compliance with industry standards and legal regulations.

Responsibilities include:

Credential newly hired clinicians with applicable insurance payers for timely billing.
Collect, Submit, & Track all necessary documentation.
Process re-credentialing for existing clinicians as required by individual payers.
Maintain a current, accurate database of all clinicians’ credentialing / licensure status, needs, expirations, issues, etc. Share with internal staff as applicable.
Communicate & Coordinate with all levels of internal staff & external stakeholders to ensure timely & consistent qualification is met & maintained.
Monitor expiring credentials to ensure ongoing compliance with regulatory guidelines.
Investigate and resolve any issues that arise during the approval process.
Under the direction of leadership, assist with site level enrollments or changes to contract.
Other duties as deemed necessary.

Requirements:

2+ years working in health plan enrollment is preferred
High attention to detail including effective communications at all organizational levels
Experience credentialing across multiple states as well as across Commercial and Medicaid payors
Experience with state Medicaid enrollment is preferred
Experience working in a team environment
Demonstrated organizational skills and ability to adhere to timelines

Preferred but not necessary:

Familiarity or experience with provider enrollment or medical licensing
Startup experience

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