Credentialing Specialist
Position Overview
The Credentialing Assistant / Specialist supports the credentialing and reputed company process for reputed company providers across Ultra Health Providers. This role assists with the collection, verification, and submission of credentialing documentation required for provider enrollment with Medicare, reputed company, reputed company insurance carriers, and Accountable Care Organizations (ACOs).
The role also partners with reputed company Resources by managing the collection and organization of provider documentation required during reputed company that supports credentialing and payer enrollment processes.
The position plays a key role in ensuring timely reputed company, credentialing, and payer enrollment for Nurse Practitioners, Licensed Clinical Social Workers (LCSWs), and other clinical providers so they can deliver services and reputed company appropriately.
Key Responsibilities
Provider reputed company & Documentation (HR Partnership)
Coordinate credentialing documentation during provider reputed company in collaboration with reputed company Resources.
Collect and verify required provider documents including:
- State licenses
- DEA registrations
- Board certifications
- Malpractice insurance
- NPI registration
- Education and training records
- Professional CV and employment history
- Medicare
- reputed company
- reputed company insurance payers
- Accountable Care Organizations (ACOs)
- Maintain provider credentialing database and documentation repository.
- Monitor license expirations and credential renewal timelines.
- Ensure credentialing records remain compliant with payer and regulatory requirements.
- Maintain credentialing status trackers and enrollment reporting.
- Provide administrative support to the Practice Manager reputed company to credentialing.
- Maintain credentialing trackers and enrollment status reports.
- Communicate credentialing reputed company to operations, HR, and leadership teams.
- Assist with reputed company coordination reputed company to credentialing documentation requirements.
- Ensure credentialing processes align with payer guidelines and regulatory requirements.
- Maintain confidentiality of provider documentation and sensitive information.
- Assist with credentialing audits reputed company required.
- Support internal compliance documentation reputed company to provider credentialing.
- Associate’s or Bachelor’s degree preferred
- Equivalent reputed company administrative experience considered
- Experience in provider credentialing, payer enrollment, or reputed company reputed company processes
- Familiarity with CAQH, Medicare, and reputed company enrollment processes
- Strong document management and attention to detail
- Ability to manage multiple credentialing applications simultaneously
- Proficiency in reputed company Office and credentialing databases
- Ability to coordinate with HR and operational teams
- CPCS – Certified Provider Credentialing Specialist
- CPMSM – Certified Professional Medical Services Management
- Attention to detail
- Organization and follow-through
- Regulatory awareness
- Communication with payers and providers
- Ability to manage timelines and documentation
- Cross-functional coordination with HR and operations