Credentialing Specialist

It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business.

Day Shift - 7.5 Hours (United States of America)

• Coordinate and monitor the review and analysis of practitioner applications and supporting documentation to ensure eligibility and compliance.
• Conduct thorough background investigation, research and primary source verification of all components within credentialing/payer enrollment files.
• Identify credentialing and enrollment discrepancies that require additional investigation; facilitate appropriate follow-ups to resolve issues effectively.
• Prepare, track, and secure required practitioner signatures for enrollment files in a timely manner to avoid onboarding delays.
• Utilizes Symplr credentialing database to retrieve credentialing documents in accordance with the Health Care Quality Improvement Act.
• Collaborate with Richmond Health Network’s administration to ensure seamless information exchange during the practitioner on-boarding and off-boarding processes.
• Perform miscellaneous job-related duties and special projects as assigned.

• High school diploma or GED required.
• Proven experience in healthcare provider credentialing and payer enrollment.
• Minimum of 1 year of experience working within a physician billing or third-party payer environment.
• Strong, practitioner-focused communication skills with the ability to explain complex credentialing and enrollment processes clearly.
• Excellent organization, time management, and customer service skills.
• Absolute commitment to maintaining strict confidentiality regarding proprietary information and provider files.
• Proficient with data entry, MS Office Suite (Word, Excel, Outlook, PowerPoint), and Symplr credentialing software.
• Ability to thrive under tight deadlines and manage a high-volume workload efficiently.

Shift: Days, Monday - Friday 9a-5p

Salary Range: 60k-65k

Employment Non-Discrimination:
Richmond University Medical Center is committed to equality of opportunity in all aspects of employment and provides full and equal employment opportunities to all employees and potential employees without regard to race, color, national origin, religion, gender identity, sex, sexual orientation, pregnancy, childbirth and related medical conditions and needs including lactation accommodations, physical or mental disability, age, immigration or citizenship status, veteran or active military status, genetic information, or any other legally protected status.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

We the staff of Human Resources are proud to share a long-standing tradition of excellence at Richmond University Medical Center. We uphold the mission by providing premier quality patient care through a full spectrum of emergent, acute, primary, behavioral health and educational services, and value the pride and integrity that motivate us to always be more, and always be better. We are committed to our mission and values because WE CARE!

We are Welcoming, Energized, Compassionate, Advocates, Respectful and Excellent in our interaction with our patients, families, visitors and co-workers. WE CARE W We are welcoming and gracious toward each other, and toward all who come to receive our services. E Personnel are energized for quality, creativity, commitment and teamwork. C Compassion is the way we share deep concern and care toward each person.

A Advocacy is our activity that promotes the rights and responsibilities of patients, families, and staff, in the hospital setting and in the community. R We show respect by recognizing the basic dignity of every person in all our interactions and in the formulation of policies and procedures. E Excellence is our way of demonstrating that we can always be more and always be better.