Credentialing Specialist

Job Description: Credentialing Specialist

Responsible to: Director of Credentialing Services

Location: Rhode Island

Under the direction of the Director of Credentialing Services, the Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing, and privileging process for all medical providers. This is a full-time in person position with benefits.

Essential Duties and Responsibilities:

• Complete provider payer enrollment credentialing and re-credentialing applications; monitors applications and follows-up as needed.
• Process applications for initial appointment and reappointment of privileges.
• Maintains strict confidentiality of provider information.
• Provides cross-coverage of duties assigned to credentialing administrative assistant.
• Perform other duties as assigned by Director to meet department needs.

Requirements:

• Bachelor’s Degree preferred or relevant experience.
• Two years of relevant credentialing experience preferred.
• Excellent data entry skills.
• Excellent organizational skills.
• Excellent verbal and written communication skills.
• Must be able to work independently with minimal supervision.
• Must be able to work in fast paced, deadline driven environment.
• Flexibility to travel between all Rhode Island and Massachusetts office sites if/when necessary.
• Ability to work in Microsoft Office and proprietary credentialing software.
• Ability to establish and maintain effective working relationships with providers, management, staff and external contacts.