Provider Credentialing Specialist
New
Z
ZeelHealthcare Administration
Must be located within the United StatesFull-TimeMiddle
Salary45,000 - 50,000 USD per year
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Job Details
- Experience
- 2–4 years
- Required Skills
- ComplianceGoogle WorkspaceHIPAA
Requirements
- 2–4 years of experience in credentialing, compliance, provider enrollment, or healthcare administration
- Familiarity with provider credentialing processes and standards (e.g., NCQA, URAC, state board licensure, NPDB)
- Strong attention to detail with the ability to manage documentation across high volumes and multiple deadlines
- Excellent communication skills and comfort working directly with healthcare professionals
- Proficiency with credentialing systems, Google Workspace, and project tracking tools
- Experience in credentialing licensed massage therapists or other allied health professionals (preferred)
- Knowledge of credentialing compliance for VA, Medicaid, or Medicare Advantage programs (preferred)
- Background in multi-state provider networks or mobile care delivery models (preferred)
- NAMSS certification (CPCS or CPMSM) (preferred)
- Experience using Salesforce, Verifiable, Evident, and Kustomer (preferred)
Responsibilities
- Conduct primary source verification of medical credentials, certifications, and background checks for new provider applicants
- Ensure all credentialing documents are collected, validated, and stored in accordance with internal policies and HIPAA standards
- Maintain and update provider records in credentialing systems and databases
- Assist with recredentialing outreach and application support
- Help manage audits, reporting, and compliance filings related to provider credentials and service eligibility
- Communicate directly with providers to request documentation and provide credentialing status updates
- Manage end-to-end provider account creation
- Track state-specific requirements, expirations, and renewal timelines
- Stay current on changes in licensure regulations and clinical credentialing standards
- Coordinate occupational health tasks including scheduling and clinical authorization management
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