Medical Staff Credentialing Specialist, Sr. processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist, Sr. loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist, Sr. handles and resolves inquiries regarding credentialing information, process, or status. May provide guidance or expertise to less experienced specialists. Requires a high school diploma. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor. The Medical Staff Credentialing Specialist, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Medical Staff Credentialing Specialist, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Pathway Healthcare is a leading behavioral health organization dedicated to providing comprehensive care for individuals facing mental health challenges, and substance abuse issues. We believe in a holistic approach to treatment, addressing both physical and mental well-being to foster lasting recovery and wellness.
We value our team members and want our team members to experience a positive culture where they feel valued. Our team members have access to health benefits, including Teladoc that is free to all full-time employees, as well as PTO, and paid holidays. If you are passionate about helping people and want to be part of a team where you will be valued and have the opportunity to grow, then send us your resume!
POSITION OVERVIEW
The Credentialing Specialist is responsible for the credentialing, enrollment, and maintenance of all assigned providers and perspective payers. Maintaining providers files with up-to-date information and communicating needed information/updates to various departments in a timely manner.
ROLE RESPONSIBILITIES
QUALIFICATIONS & EDUCATION REQUIREMENTS