Credentialing Specialist

Job description

Credentialing Specialist

Based in Rockville, MD

Salary $65,000 to $75,000

Who We Are

The Center for Innovative GYN Care (CIGC) seeks an enthusiastic Credentialing Specialist to join our team in Rockville, MD.

What We Do

• We’re setting the new gold standard in GYN surgery. Here at CIGC, we provide our patients world class surgeons; state-of-the-art surgical techniques; an enhanced, personalized patient experience; and price transparency prior to surgery with the lowest out of pocket cost. The result? Better care. Improved outcomes. Fewer recurrences. Higher satisfaction. The lowest out-of-pocket costs in the US.
• Our surgeons have revolutionized GYN surgery by developing and perfecting patented, state-of-the-art surgical techniques for the most common and complex GYN conditions that increase safety, reduce recovery time, and improve health outcomes, including fertility preservation, so our patients can get back to their lives sooner.

Who You Are

• We are looking for an individual that believes in our mission. The Credentialing Specialist is a critical member of the team, assisting in the licensing and credentialing of all CIGC. The successful candidate should be detail oriented, with excellent communication skills and experience working in health plan credentialing.

Your Contributions

• Responsible for all aspects of the credentialing, recredentialing and privileging processes for all medical providers, who provide patient care under CIGC and its Ambulatory Surgery Centers (ASC), in multiple states. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure & provide timely renewal of licensure and certifications for providers in multiple states.

Major Responsibilities

• Compiles and maintains current and accurate data for all providers, in multiple states.
• Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed. Includes all states of practice. Knowledge of multiple states’ licensure nuances.
• Completes applications, and maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers, in multiple states.
• Knowledge of carrier/provider contract files for multiple states.
• Maintains knowledge of current health plan and agency requirements for credentialing providers, in multiple states.
• Sets up and maintains provider information in online credentialing databases and systems, as indicated.
• Tracks license and certification expirations for all providers to ensure timely renewals.
• Ensures practice addresses are current with health plans, agencies, and other entities.
• Processes applications for appointment and reappointment of privileges to our ASC’s.
• Tracks license, DEA, and professional liability expirations for appointed ASC providers.
• Maintains ASC appointment files. Coordinates reappointment.
• Audits health plan directories for current and accurate provider information
• Maintains confidentiality of provider information.
• Provides credentialing and privileging verifications.
• Performs other duties as assigned.

Preferred Experience

• We understand that your experience is more than just a list of requirements, so we encourage you to apply even if you don't meet all the following qualifications:

Education: Associate degree or above.

Knowledge and understanding of the credentialing process.

Ability to organize and prioritize work and manage multiple priorities.

Excellent verbal and written communication skills including letters, memos, and emails.

Excellent attention to detail.

Ability to research and analyze data.

Ability to meet deadlines

Ability to work independently with minimal supervision.

Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.

Proficient use of Microsoft Office applications (Word, Excel, Teams) and internet resources.

Benefits

• We are committed to providing our employees with the support they need. At CIGC, we offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision, and 401K.

Job Type: Full-time

Salary: $65,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Rockville, MD 20852: Reliably commute or planning to relocate before starting work (Preferred)

Education:

• High school or equivalent (Preferred)

Experience:

• Credentialing: 5 years (Preferred)

Work Location: In person

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Job Type: Full-time

Pay: $65,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Education:

• Associate (Required)

Experience:

• Credentialing: 5 years (Required)

Work Location: In person