Credentialing Specialist Job at EPITEC, Detroit, MI

aGVXWmR2RVhmYlhySksxdjExN2NyTXQ4TXc9PQ==
  • EPITEC
  • Detroit, MI

Job Description

Job Description

Credentialing Specialist

Join our team of dedicated professionals and play a critical role in ensuring the smooth operation of our credentialing and recredentialing processes. As a Business Analyst, you will be responsible for processing practitioner and organization/facility provider applications, verifying information, and updating records in our system of record. If you have a passion for detail, excellent communication skills, and experience in provider enrollment or credentialing, we want to hear from you.

Key Responsibilities:

  • Process practitioner and organization/facility provider applications for credentialing and recredentialing
  • Verify primary source documentation and evaluate case categorization
  • Provide credentialing status information to various stakeholders
  • Assist with special projects and job aids as needed
  • Attend Credentials Committee meetings and participate in auditing processes

Required Skills and Experience:

  • 2-5 years of work experience in provider enrollment, contracting, medical practice, or hospital business office role and/or credentialing related field
  • Knowledge of related state/federal regulations, NCQA, DIFS, MDHHS, and CMS standards for credentialing
  • CAQH knowledge required
  • Excellent organizational skills with attention to detail
  • Excellent verbal and written communication skills
  • Ability to handle and prioritize multiple case files and timelines
  • Ability to work effectively independently or in a team environment
  • Intermediate knowledge of Microsoft Word, Excel, Access, PowerPoint, and internet use

Nice to Have Skills:

  • Excellent interpersonal skills and the ability to interact with internal/external customers
  • Experience with auditing processes and internal meetings

Job Tags

Work experience placement, Work at office,

Similar Jobs

AO Globe Life

Remote Customer Service Representative - Entry Level | Weekly Pay + Benefits Job at AO Globe Life

 ...Join Our Team Today Start Your Remote Career Now! Looking for a stable, rewarding career where you can work from home, get paid weekly, and grow long-term ? This...  ...bonuses, and nationwide opportunities . No experience required just bring your drive to succeed.... 

FanDuel

Senior Machine Learning Engineer Job at FanDuel

ABOUT FANDUEL FanDuel Group is the premier mobile gaming company in the United States and Canada. FanDuel Group consists of a portfolio of leading brands across mobile wagering including: Americas #1 Sportsbook, FanDuel Sportsbook; its leading iGaming platform, FanDuel... 

ThinkTank

Junior Network Engineer (1-3 yrs exp) Job at ThinkTank

Overview Join to apply for the Junior Network Engineer (1-3 yrs exp) role at Think Tank Inc.Location and CitizenshipUS Citizenship Required; On-site in Fairfax, Virginia, onlyRequirements Think Tank is a woman-owned small business with more than 27 years of proven success... 

Brykin Works Llc

Handyman Job at Brykin Works Llc

 ...Installing blinds Painting Drywall repair Looking for subcontractor that wants to be paid per job Company Description Small handyman company that prides its self on doing great work. Company Description Small handyman company that prides its self on doing... 

ARVADA APPLIANCE

Home Appliance Repair Technician Job at ARVADA APPLIANCE

 ...Flexible Scheduling Competitive Compensation Career Advancement Opportunities Job Summary We are seeking a skilled Appliance Repair Technician to join our team. In this role, you will travel to customers homes and businesses, install new appliances, and...