At this time, we are in search of a full time Senior Credentialing Specialist to join the team in our Cranberry Township, PA office. The Senior Credentialing Specialist is responsible for the credentialing process for new providers in health plans and the re credentialing of exiting providers by collecting and processing significant amounts of verification and accreditation information. The position is responsible for following all compliance, Medicare and HIPAA policies.
- Act as the main point of contact in regards to the credentialing process for the company.
- Process initial applications and re credentialing applications for new and current providers.
- Follow-up on application status as needed.
- Coordinate with other departments and vendors to collect and verify credentialing information.
- Set-up, maintain, and update both paper and electronic files and databases for providers and facilities.
- Maintain credentialing information with insurances and providers.
- Maintain current corporate provider contract files.
- Set up new facilities with insurances and research what insurances are available in the area.
- Maintain knowledge of current health plan and agency requirements for credentialing providers.
- Gather and maintain current copies of state licenses for all providers.
- Track state licenses expiration dates.
- Complete all other tasks and duties as assigned.
Qualifications and Skills
- High School Diploma or equivalent; post-secondary education preferred.
- 3 to 5 years of previous credentialing experience required.
- Experience in a healthcare environment preferred with knowledge and understanding of the credentialing process.
- Proficiency with Microsoft Office tools with a sharp technical aptitude.
- Ability to communicate effectively and professionally with a wide variety of people.
- Strong organizational skills with attention to detail and accuracy.
- Ability to handle multiple tasks in a very busy environment.
- Demonstrates continued interest in self and professional development.
PHOENIX offers a competitive salary and benefit package that includes PTO, and optional participation in health, dental, vision, life and disability insurances, and a 401(k) plan. All interested candidates should submit their resumes to Michelle Manarelli – HR Coordinator at firstname.lastname@example.org
PHOENIX is an E-Verify and Equal Opportunity Employer.