Provider Credentialing Specialist - 100% Remote
Company: nTech Workforce
Posted on: June 25, 2022
Terms of Employment
- W2 Contract-to-Hire, 6 Months
- Location: Remote
- Training: First week not to exceed 2 in person onsite training
days per week in Columbia. Responsibilities
- Analyzes and researches credentialing applications/provider
contracts to verify that appropriate information has been obtained
as well as handles incoming and outgoing correspondence regarding
the applications. Determines the appropriate networks for
participation and obtains the appropriate executed contracts.
Maintains the on-line provider file and hardcopy file with updated
provider information- Credentials and re-credentials providers to
appropriate levels. Maintains the Application Log in accordance
with state legislation.(35%)
- Assign provider numbers and updates demographic information on
the corporate database for publishing provider information in our
various directories. Processes applications and updates in
accordance with applicable state laws and guidelines. Maintains
database for all provider information updates to support corporate
mainframe system for all network provider or subscriber inquiries
and is fundamental in supporting the provider special pricing
- The incumbent addresses questions involving professional
- Contractual questions. Determines the nature of inquiry,
researches available information and determines the proper actions
required. Responds to external and internal inquiries regarding
provider participation eligibility and criteria, participation
status and provider file updates.(20%)
- Prepares written responses in order to obtain incomplete or
missing information. Mails appropriate provider packet when
required. Mails confirmation letter to professional providers
identifying necessary provider numbers for proper
- Perform other job-related duties or special projects as
- Supervisory Responsibility
- This position has no supervisory responsibilityRequired Skills
- High school diploma with 2 years of college or commensurate
- 3-5 years direct experience with provider contracting,
credentialing or network management.
- Credentialing or Provider file maintance experience.
- Analytical Skills to research and analyze data.
- Knowledge of medical terminology.
- Strong service skills and possess ability to remain calm in
stressful situations with medical professionals.
- Experience working on a diverse team and collaborating on
- Demonstrated success in handling large volumes of work .
- Effective verbal and written communication skills.
- Ability to work as a member of a team.
- Familiarity with PC and mainframe applications.
- Ability to organize, prioritize, and accomplish tasks within
- Ability to prioritize multiple tasks and remain focused.
- Demonstrated proficiency utilizing reference materials.
- Must be able to effectively work in a fast paced environment
with frequently changing priorities, deadlines, and workloads that
can be variable for long periods of time.
- Able to meet established deadlines and handle multiple customer
service demands from internal and external customers, within set
expectations for service excellence.
- Effectively communicate and provide positive customer service
to every internal and external customer, including customers who
may be demanding or otherwise challenging.
- Top Skills:
- Credentialing/Data Entry/Analytical Thinking/Customer Service
- Excellent communication (oral and written).
- Knowledge in Microsoft Office and Excel required.
- Strong organizational skills.Preferred Skills & Experience
- Medical/Healthcare terminology and Certified Provider
Keywords: nTech Workforce, Cleveland , Provider Credentialing Specialist - 100% Remote, Other , Cleveland, Ohio
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