Credentialing Specialist

Robert Half Remote
credentialing credentialing data database written scanning interpret departmental written communication communication communication skills team status reports
March 20, 2023
Robert Half
Richmond, VA
Core duties and responsibilities include the following. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

Manual Entry of Practitioner information into the credentialing data base in a timely manner
Ability to read, extract and interpret information comparing such to established departmental policies. Maintains a computerized database of practitioner data for use in the credentialing & enrollment process
Excellent verbal and written communication skills
Self-motivated with the ability to complete projects independently within established timelines
Ensures workload deadlines are being met in a consistent manner
Must be flexible and willing to work extra hours during peak workloads and deadlines
Ability to problem solve, make decisions and effectively communicate
Ability to work productively within a team
Prepares and provides reports, recredentialing applications, status reports, expired items reports and completed file reports to assure time frames are met and filing and scanning when necessary
Accurately perform a variety of administrative duties such as: placing calls, processing facsimile verifications, scanning, sending written inquires, filing and copying.
Pursue incomplete information in reference to provider health plan enrollment
Ensures consistent & complete verification of practitioners credentialing/recredentialing and privileging
Maintains a computerized database of practitioner data for use in the credentialing/recredentialing and privileging process
Generates verification letters, and upon receipt of verification letters, logs the appropriate response in the Credentialing database
Maintains detailed credentialing/recredentialing and privileging files in electronic format, including electronically received documents, and document each stage of credentialing/recredentialing and the privileging process thoroughly


Credentialing, Physician Credentialing, Provider Credentialing, Certified Provider Credentialing

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