Medical Credentialing Specialist - Healthcare Services

Schedule:

• Part-time, flexible, minimum 20 hours per week
  

Client Timezone: Eastern Time, NY

Join a pioneering healthcare services company at the forefront of streamlining medical practice operations. This innovative firm specializes in crucial behind-the-scenes work that enables healthcare providers to focus on patient care. By managing complex credentialing processes and insurance enrollments, the company plays a vital role in ensuring seamless healthcare delivery across the United States.

As a Medical Credentialing Specialist, you’ll be instrumental in navigating the intricate landscape of healthcare administration. Your expertise will directly impact healthcare providers’ ability to serve patients efficiently. You’ll manage the critical process of credentialing and contracting with various insurance entities, including Medicaid, Medicare, and private insurers. This role offers a unique opportunity to apply your specialized knowledge in a dynamic, ever-evolving field, contributing significantly to the smooth operation of healthcare practices nationwide.

• Spearhead the processing and management of credentialing applications for diverse healthcare providers
  
• Conduct meticulous reviews of provider credentials, ensuring strict compliance with regulatory standards
  
• Lead negotiations and oversee contracts between healthcare providers and insurance companies
  
• Maintain a comprehensive, up-to-date database of provider credentials, proactively managing renewals
  
• Stay at the cutting edge of credentialing regulations and insurance requirements, adapting processes as needed
  
• Collaborate with healthcare providers to streamline their credentialing and enrollment processes
  
• Troubleshoot and resolve complex credentialing issues, acting as a subject matter expert
  

• Proven track record with 2-3 years (preferably more) of hands-on experience in medical credentialing, ideally within the U.S. healthcare system
  
• Comprehensive understanding of Medicaid, Medicare, and private insurance credentialing processes
  
• Strong background in healthcare regulations and compliance requirements
  
• Exceptional attention to detail coupled with superior organizational skills
  
• Proficiency in relevant credentialing software and tools
  
• Ability to manage multiple provider accounts across various medical specialties
  
• Excellent communication skills for effective interaction with providers, insurance representatives, and team members
  
• Adaptability to work in a fast-paced, evolving healthcare environment
  
• Preference for candidates with experience working in American companies