Job Description

Job Description

Job Description

We are looking for a dedicated Credentialing Specialist to join our client's team in Indianapolis, Indiana. In this role, you will oversee the credentialing, re-credentialing, and privileging processes for medical staff while ensuring compliance with public and private payer requirements. This position is ideal for someone who is highly organized and committed to maintaining high standards in healthcare operations.

This role offers a hybrid schedule, excellent benefits, and opportunity for growth.

Responsibilities:

• Manage credentialing, re-credentialing, and privileging processes for medical staff to ensure compliance with regulatory requirements.

• Enroll healthcare providers in applicable public and private payer organizations, maintaining accurate records.

• Monitor and track the expiration dates of licenses, certifications, and other required documents to facilitate timely renewals.

• Coordinate with the Payer Relations Manager to ensure proper alignment of provider credentials with payer contracts.

• Maintain and update provider demographic information across all healthcare payer systems.

• Audit health plan directories to ensure the accuracy and currency of provider information.

• Generate and analyze reports related to credentialing and provider compliance as needed.

• Stay informed on current health plan and facility requirements for credentialing processes.

• Uphold confidentiality of sensitive provider information in all documentation and communications.

• Minimum of 2 years of experience in credentialing within the healthcare industry.
• High school diploma required; a college degree is preferred.
• Valid driver’s license and automobile insurance are mandatory.
• Proficiency in provider credentialing systems, such as CAQH, is essential.
• Strong understanding of payer requirements and healthcare provider regulations.
• Excellent organizational and time-management skills to handle multiple tasks effectively.
• Ability to work collaboratively with cross-functional teams to meet credentialing and compliance goals.
• Attention to detail and commitment to maintaining high standards of data accuracy.

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