Medical Credentialing Specialist
CIMPAR is seeking a motivated full-time Credentialing Specialist to manage the end-to-end credentialing process. You'll handle tracking, file reviews, issue resolution, and roster auditing, ensuring our providers are credentialed and compliant.
Key Responsibilities:
Coordinate onboarding for new providers
Maintain accurate data for all service locations
Complete and monitor provider payer enrollment applications
Handle credentialing applications and re-credentialing processes
Ensure compliance with State of Illinois requirements
Maintain copies of licenses, DEA certifications, and malpractice coverage
Stay updated on health plan and agency credentialing requirements
Manage provider information in credentialing databases
Track license and certification renewals
Ensure practice addresses are current with health plans and agencies
Audit health plan directories for accuracy
Provide credentialing and privileging verifications
Monitor and follow up on credentialing processes with third-party payers
Communicate updates to management and billing departments
Build professional relationships with third-party payers
Research and resolve claim issues related to non-payment
Qualifications:
Strong administrative skills
Problem-solving and analytical skills
Proficient in computer applications
Excellent communication skills
Strong organizational abilities
Ability to multitask and maintain confidentiality
Experience in credentialing, preferably in a medical office setting
Credentialing software experience is a plus
Education:
High school diploma or equivalent (Required)
Credentialing Certification (Preferred)
Benefits:
Health insurance, dental, vision, paid time off, major holidays off, mileage reimbursement
Work Remotely:
No
Join us to make a significant impact in a dynamic healthcare environment!