We are seeking a meticulous and experienced Healthcare Credentialing Specialist to join our team and ensure our healthcare providers are fully credentialed and compliant. The Healthcare Credentialing Specialist is responsible for managing the entire credentialing and re-credentialing process for our healthcare providers. This role requires a good understanding of credentialing standards, regulations, and best practices. The ideal candidate will be highly organized, detail-oriented, and possess excellent communication skills.
...
Responsibilities:
Manage the full credentialing lifecycle, including initial applications, re-credentialing, and expirables tracking.
Verify provider credentials, including education, licenses, certifications, and professional affiliations.
Maintain accurate and up-to-date provider credentialing files and databases.
Communicate effectively with providers, insurance companies, hospitals, and other relevant organizations.
Monitor and ensure compliance with all applicable federal, state, and local regulations, as well as accrediting body standards (e.g., NCQA, TJC).
Prepare and submit credentialing applications and supporting documentation.
Track the status of applications and follow up as necessary.
Resolve credentialing issues and discrepancies promptly.
Assist with audits and reporting as required.
Stay current with industry trends and changes in credentialing requirements.
Maintain confidentiality of sensitive provider information.
Working hours: 8:00 AM - 5:00 PM
Skills:
Degree is preferred
Proficient in using credentialing software and databases.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator (CMSC) is a plus.
Education:
High School
Experience:
1-4 years
Qualifications:
Minimum 1 year of experience in healthcare credentialing.
Knowledge of credentialing and privileging processes.
Excellent organizational, time management, and problem-solving skills.
Attention to detail and accuracy.
Excellent written and verbal communication skills.
Ability to work independently and as part of a team.
Apply online at www.spherion.com/apply
Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).