Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist in Managed Care.

Key Responsibilities

• Coordinate and monitor the credentialing and re-credentialing process for healthcare providers
• Conduct thorough background investigations and ensure the accuracy of credentialing files
• Prepare credential files for presentation to credentialing committees and respond to inquiries regarding credentialing issues

Required Qualifications, Training, and Education

• High School Diploma or equivalent
• Certified Professional Medical Staff Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) required
• Knowledge of medical credentialing and privileging procedures
• Database management skills, including querying and reporting
• Administrative support experience in a healthcare setting