Credentialing Specialist
New
Must Reside in North CarolinaFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- One year of experience in a Medical Staff credentialing office.
Requirements
- Bachelor's degree or four years of relevant Medical Staff Credentialing experience in lieu of degree.
- One year of experience in a Medical Staff credentialing office.
- Strong analytical, communication, and organizational skills.
- Knowledge of state/federal laws and regulatory standards for accreditation.
- Proficiency in maintaining complex databases.
- NAMSS certification (CPCS/CPMSM) is preferred.
Responsibilities
- Processes initial applications for DUHS ensuring regulatory compliance.
- Obtains primary source verification for all regulatory requirements.
- Researches and maintains accurate data for providers in the credentialing database.
- Executes NPDB queries for initial applications.
- Analyzes application information to ensure no time gaps and adherence to policies.
- Maintains database integrity including licenses, DEA certificates, and insurance data.
- Serves as a subject matter expert on credentialing administration and policies.
- Prepares formal correspondence and reports for internal/external circulation.
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