Credentialing Specialist

Credentialing Specialist

The Credentialing Specialist is responsible to coordinate and assist with the day-to-day administrative functions of the Department. The selected candidate will have excellent written communication skills, able to multitask and manage time effectively and provide administrative support to the Delegation team within the Credentialing Department.

Key Responsibilities:

• Efficient and timely completion of confidential Medicaid applications for provider enrollment, group affiliations, and ETIN enrollment/ maintenance.
• Follow established timelines for processing and completion of applications
• Critically evaluate application for any issues that may require special consideration, or additional review, and take appropriate action to resolve issue
• Identify providers whom are due for ETIN recertification and escalate to supervisor appropriately
• Coordinate with appropriate credentialing onboarding staff to obtain required information from provider
• Perform self-audit of work to ensure data integrity before mailing applications
• Document all tasks, phone calls, emails and other forms of communication during the application process.
• Update rest of Medicaid team and onboarding platform once mailed
• Assist to track the status of mailed applications, if needed
• Provide status updates to Credentialing Department's leadership within one business day, from receipt of request
• Work with supervisor in identifying back-up coverage when out of the office
• Timely and complete updates of credentialing software
• Complete other related tasks or projects as assigned
• Provide back-up to other Credentialing staff as necessary
• Ensure providers files have up to date forms for Medicaid revalidations and yearly certifications.
• Communicate with all levels of organization to obtain documentation and signatures.

Competencies:

• Able to multitask, prioritize, and manage time efficiently
• Excellent verbal and written communication skills
• Strong interpersonal and communication skills with an ability to work effectively with a wide range of people, teams, managers, supervisors, and vendors.
• Proficient with MS Office (outlook, word, excel, power point, access)

Qualifications:

• Bachelor's Degree in a Health-Related Discipline:
  Public Health, Healthcare Administrative, Health Service, Psychology or Sociology Highly Preferred, or in process
• High School Diploma Required
• Hands on experience supporting healthcare credentialing and enrollment functions preferred
• Notary a plus

ESSEN HEALTH CARE IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER

Essen Healthcare is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically-diverse population.