Credentialing Specialist

Long Term Temporary, Potential Temporary to Direct Hire, Credentialing Specialist Opportunity available in NYC.

This is an onsite, Monday through Friday, 9am to 5pm position.

Responsibilities:

• Collaborate with unit supervisor to approve individual provider applications.
• Conduct initial audit and ongoing delegated entity reviews, follow-up and communicate findings interdepartmentally as appropriate.
• Processes Delegated spreadsheets for Credentialing “Delegated Approvals” and identifies key components missing on spreadsheet for approvals.
• Communicate with Delegated Entity to obtain missing information from delegated spreadsheets that affects credentialing approvals.
• Coordinates Credentialing and Recredentialing Non-Responding provider outreach with Data Integrity Unit and collaborate with Network Management to vet application closure when applicable.
• Perform additional duties and projects assigned by management.

Qualifications

• Bachelors Degree preferred. High School Diploma or GED required
• Minimum of 2 years of credentialing experience in a managed care or medical environment required.
• Minimum two (2) years administrative experience in a general office environment.
• Proficiency in Microsoft Word and Excel required
• Excellent interpersonal and communications skills - both written and verbal
• Strong analytical, problem-solving, time management, planning and organizational skills