Credentialing Specialist jobs in Edmond, OK

Credentialing Specialist / Lead | OKC, OK

Pay: $20-$24/HR, DOE

***5 Years of Credentialing Experience Required***

Hours: Full-Time, M-F 8a-5p

POSITION SUMMARY- The credentialing specialist will verify the credentials of health care providers in accordance with state and federal standards. This involves verifying the legitimacy of practitioner information with universities, licensing agencies, and certification groups. The credentialing specialist will process enrollment, credentialing and re-credentialing paperwork as required by health plans and government programs. The credentialing specialist should be detail orientated and capable of maintaining a database with up-to-date provider information.

The credentialing specialist should have strong oral and written communication skills. They will communicate regularly with health plans via email and phone to ensure the credentialing status of providers is on track. The credentialing specialist will act as a liaison and communicate directly with providers when additional information or documentation is required for their credentialing.

ESSENTIAL FUNCTIONS

· Verify the legitimacy of practitioner information with universities, licensing agencies, and certification groups

· Complete credentialing and re-credentialing applications for government payers, commercial payers and medical staff offices

· Follow lengthy credentialing processes until effective dates are assigned

· Track and assist with license renewals

· Update and pull reports from credentialing database

· Other tasks to support the credentialing team

QUALIFICATIONS

· Bachelor degree or minimum four years of healthcare experience

· Ability to work in a fast paced environment

· Excellent professional communication skills, both written and verbal

· Ability to work independently, set priorities and meet deadlines

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