Credentialing Specialist

Posted In: Brooklyn, New York


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Job Description:

Responsible for all aspects of new and existing provider credentialing and re-credentialing including initial application for all providers.
Complete credentialing applications to add providers to commercial payers, and Medicaid.
Review credentialing application for completeness and log any missing documentation
License Renewals: Ensures that physician licenses are renewed prior to expiration.
Records Management: Maintains assigned physician files, updating each item/action as processed
Ensure that information is current and accurate and ensure appropriate follow-up with Insurance carriers
Knowledge and experience with CAQH, Availity, NPI type 1 and 2.
Maintain confidential and sensitive information with discretion.
Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
Required knowledge, skills and abilities:

Knowledge of provider credentialing with a minimum of two years of previous experience preferred
Excellent computer skills including Excel, Word, and Internet use
Detail oriented with above average organizational skills
Plans and prioritizes to meet deadlines
Communicates clearly and effectively
Strong attention to detail and ability to manage multiple tasks simultaneously
Excellent communication and interpersonal skills, with the ability to work collaboratively with staff and providers.

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Contact Info

Phone: 718-872-6051

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