Top 5 Credentialing specialist Jobs in Wilmington De

Credentialing and Licensure Specialist
Upward Health —Philadelphia, PA
- $65,000 a year
- Remote
- Mid-level
- Databases
- Organizational skills
Quick Apply
Credentialing & Provider Enrollment Specialist
Greater Philadelphia Health Action —Philadelphia, PA
- Hybrid work
- Customer service
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
Credentialing Specialist
One Federal Solution —Philadelphia, PA
- Customer service
- Mid-level
- Administrative experience
Quick Apply
8d
HSPD-12: Government Badging & Credentialing Specialist (Philadelphia, PA*)
Citizant Inc —Philadelphia, PA
- $19.72 an hour
- Full-time
- Administrative experience
- High school diploma or GED
- Organizational skills
- Disability insurance
- Health insurance
Quick Apply
HR & Credentialing Specialist
AMBASSADOR ACADEMY ROBOTS & MENTORS —Philadelphia, PA
- $22 - $25 an hour
- Full-time
- Mid-level
- Office
- Children
- Opportunities for advancement
Quick Apply

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Credentialing and Licensure Specialist
Upward Health —Philadelphia, PA
Though not a supervisory position, exhibits leadership qualities by driving efficiency, offering guidance, and ensuring team alignment on goals.
$65,000 a year
Quick Apply
Credentialing & Provider Enrollment Specialist
Greater Philadelphia Health Action —Philadelphia, PA
Successful candidates will have at least two to four years of college education plus a minimum of two years’ credentialing experience in a Health Center…
Quick Apply

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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…

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Credentialing and Licensure Specialist

Upward Health -
Philadelphia, PA

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Job Details

$65,000 a year

Qualifications

Provider database maintenance for medical credentialing
Provider enrollment for medical credentialing
Patient management software
Databases
Health insurance knowledge
Clinical information systems
Healthcare provider information
Manual chart audits
Productivity software
Defect tracking tools
Cross-functional collaboration
Documentation review
Cross-functional communication
Office record organization

Full Job Description

Company Overview:

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It's no wonder 98% of patients report being fully satisfied with Upward Health!

Job Title & Role Description:

The Credentialing and Licensure Specialist will join the Upward Health Business Services team to assist in a range of activities with the team. There will be primary focus on assisting our Credentialing and Licensure Supervisor with nursing and provider licensure efforts and associated credentialing efforts. The role will also participate in payer audit needs when/if needed. position requires attention to detail, strong organizational skills, and the ability to manage a dynamic workload. This role reports to the Credentialing and Licensure Supervisor.

Skills Required:

Proven background in credentialing, with experience handling both individual and group credentialing applications.
Ability to create and maintain databases for credentialing approvals and processes with reporting across multiple internal teams.
Understanding of medical record reviews and chart audits, and an ability to navigate EHRs
Understanding of the healthcare industry, particularly in working with health insurance companies, healthcare provider organizations, or other healthcare services companies.
Ability to manage complex processes and maintain accuracy across multiple provider records.
Strong verbal and written communication skills to collaborate effectively with internal teams and external stakeholders.
Ability to prioritize tasks and manage competing deadlines in a fast-paced, goal-oriented environment.
Comfort with using various software programs, including Microsoft Office, Jira, and clinical applications (EHR, care management systems).
Demonstrated ability to adjust to evolving priorities and workload demands in a virtual, dynamic environment.

Key Behaviors:

Accountability:

Takes ownership of the credentialing process, ensuring all tasks are completed in a timely and efficient manner.

Collaboration:

Works well with cross-functional teams, maintaining open communication and contributing to a positive, supportive work environment.

Attention to Detail:

Demonstrates exceptional focus on detail, ensuring that all submissions and approvals are accurate and tracked.

Flexibility:

Adapts quickly to changing processes, priorities, and workload, managing multiple responsibilities without compromising quality.

Professionalism:

Maintains a professional approach with both internal and external stakeholders, exemplifying Upward Health's values at all times.

Competencies:

Problem-Solving:

Capable of identifying issues and developing solutions independently while managing the complexities of the credentialing process.

Organization:

Effectively manages multiple tasks, timelines, and deadlines while keeping records organized and up-to-date.

Communication:

Clearly communicates processes, updates, and issues with both team members and external parties.

Customer Focus:

Demonstrates a strong commitment to understanding and meeting the needs of both internal teams and external health plan representatives.

Leadership:

Though not a supervisory position, exhibits leadership qualities by driving efficiency, offering guidance, and ensuring team alignment on goals.

Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.

Upward Health Benefits

Upward Health Core Values

Upward Health YouTube Channel

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Refine Your Search

credentialing specialist jobs in wilmington de

Credentialing and Licensure Specialist

Credentialing & Provider Enrollment Specialist

Credentialing Specialist

HSPD-12: Government Badging & Credentialing Specialist (Philadelphia, PA*)

HR & Credentialing Specialist

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