Credentialing Specialist
Core
Create and maintain credentialing and renewal information for telemedicine providers to ensure accurate payor directory listings and resolve authorization issues.
Role type
Administrative Credentialing Specialist
Builds
Provider credentialing status and payor directory accuracy
Domain
Healthcare revenue cycle / Telemedicine
Deliverable
dashboards & analysis
Required skills
HIPAA compliance, CAQH management, payer portal navigation, data verification, database maintenance, policy adherence
Preferred skills
Billing experience, collaboration, organization
Technologies
CAQH, payer portals, credentialing databases
Responsibilities
Follow and maintain credentialing and clinic licensure policies; Ensure reports on provider credentialing status are up-to-date; Process applications and verify information; Complete revalidation requests issued by payers; Monitor staff credentials and licenses; Work with billing staff to resolve denials or authorization issues. (via careerplan.io/jobs/4401115009-credentialing-specialist-at-workithealth)
Seniority
Mid-level, individual contributor