Credentialing Specialist

$49,920 - $49,920/Yr

TEKsystems - Newnan, GA

Full-time - Entry Level

Remote - Newnan, GA

10,001+ employees

Professional, Scientific, and Technical Services

About the position

The Credentialing Specialist at TEKsystems is responsible for managing the complete credentialing process for healthcare providers, ensuring compliance with regulations and standards. This role involves conducting primary source verifications, maintaining credentialing databases, and overseeing the timely submission of credentialing applications. The specialist must demonstrate strong organizational skills and professionalism while effectively communicating with various stakeholders.

Responsibilities

• Manage the end-to-end credentialing process for healthcare providers, including initial applications and re-credentialing.
• Conduct thorough primary source verifications to ensure the accuracy and validity of credentials.
• Complete hospital and payer credentialing processes, maintaining compliance with all regulations and standards.
• Maintain and update CAQH profiles and other credentialing databases with meticulous attention to detail.
• Oversee credentialing applications, ensuring timely submission, tracking, and resolution of any issues in a fast-paced environment.
• Demonstrate the ability to prioritize tasks effectively while adapting to changing priorities and requirements.
• Maintain a high level of professionalism in all interactions with providers, internal teams, and external organizations.
• Actively monitor credentialing deadlines and ensure timely renewals of licenses, certifications, and privileges.
• Communicate effectively with internal and external stakeholders to resolve credentialing-related inquiries or concerns.

Requirements

• Strong organizational and time management skills, with the ability to meet tight deadlines.
• Exceptional attention to detail and accuracy in data entry and documentation.
• Ability to pivot and adapt to new priorities or unexpected changes in direction.
• Demonstrated professionalism, accountability, and problem-solving skills.
• Excellent communication skills, both written and verbal.

Nice-to-haves

• Experience with credentialing software such as Medicred.
• Familiarity with healthcare regulations and standards.

Benefits

• Medical, dental & vision insurance
• Critical Illness, Accident, and Hospital coverage
• 401(k) Retirement Plan with Pre-tax and Roth post-tax contributions
• Voluntary Life Insurance & AD&D for the employee and dependents
• Short and long-term disability insurance
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Paid Time Off (PTO), Vacation or Sick Leave