Credentialing Specialists (Experience in CSU and VMS Credentialing)

PLEASE DO NOT APPLY IF YOU DO NOT HAVE CSU and VMS Credentialing Experience!

Company Overview:

We are a leading healthcare organization committed to providing exceptional patient care. As part of our growth strategy, we are seeking a dedicated Credentialing Specialist.
The Credentialing Specialists is responsible for ensuring that the facilities in which they work and represent are fully compliant with all state and federal regulations. They must also ensure that every staff member is legally licensed and/or credentialed and up to date with the latest medical policies and procedures.
Responsibilities:
• Create and maintain licensing, credentials, and insurance records
• Maintain current provider data in credentialing databases, ensuring timely license and certification renewals.
• Develop and manage detailed credentialing grids for network participation clarity.
• Verify healthcare professionals’ credentials in compliance with state and federal standards, involving verification with universities, licensing agencies, and certification groups.
• Process re-credentialing paperwork and maintain a database of practitioners’ training, education, licensing, and experience information.
• Ensure practitioners adhere to staff policies, department regulations, and government laws.
• Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institutions
• Participate in other admin task

Qualifications and Skills:
• Someone that has an experience with CSU and VMS Credentialing
• Strong multitasking abilities with a track record of managing multiple projects simultaneously.
• Familiar with the US medical insurance industry
• Minimum of 2 years experience in US-based Credentialing process
• Ability to build and maintain effective relationships with providers, management, staff, and external contacts.
• Demonstrated history of completing credentialing projects from start to finish.
• Project management skills with the ability to supervise others’ work.
• Adherence to instructions and payer-specific guidelines.
• Highly organized and meticulous in maintaining digital files and relevant information.
• Excellent verbal and written communication skills for letters, memos, and emails.
• High comfort level working on Eastern US Shift
If interested, PLEASE EMAIL YOUR UPDATED RESUME to Edrich at Click to view, use the subject: “Experienced Credentialing Specialist – (Include Your Name)”