Job Description
Credentialing Specialist
Minimum 5 years of experience in recent Provider Enrollment/Credentialing
Contract location ONSITE in Phoenix, AZ 85008
Monitor provider credentialing and re-credentialing, ensuring timely completion of required documents.
Verify provider qualifications, licenses, certifications, and educational background.
Submit enrollment applications and monitor application statuses.
Prepare files for credentialing committee meetings, generate reports for credentialing status and process improvement.
Keep provider information up to date and communicate changes to stakeholders.
Coordinate with providers, insurers, and internal teams regarding credentialing.
Implement systematic recredentialing and monitor credential expirations.
Work with other departments to integrate credentialing and billing.
Provide training to providers and staff on credentialing processes.
What you bring:
Minimum of 5 years of experience in Provider Enrollment
Credentialing for Hospital and Mental Health is a plus
Knowledge of Medicare and Medicaid, Commercial plans
Knowledge of NPPES, CAQH
Ability to multi-task effectively, work individually as well as in a team environment
High efficiency in problem resolution
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