Apply on Employer Site

Anders · 4 weeks ago

Credentialing Specialist

St. Louis, MO

Full-time

Onsite

Mid Level

$21/hr - $27/hr

3+ years exp

Anders CPA Advisors is one of the fastest-growing Credentialing Verification Organizations in the country, seeking a Credentialing Specialist who is motivated to learn and passionate about delivering outstanding results. The role involves managing credentialing applications, ensuring compliance with regulatory standards, and maintaining effective communication with applicants and facilities.

Accounting

No H1B

Responsibilities

Application management and verification activities, preliminary analysis of application and verification information, and analyzing verification information, to include identifying red flag and/or adverse information

Ability to research and analyze documents utilizing strong documentation skills with high attention to detail

Maintain timely communication with applicants and member organizations on the status of the application files and any required documents or information needed to complete the medical credentialing process

Monitoring expiring information such as, but not limited to, federal and state DEA, state professional license(s), professional liability insurance, and specialty board certification status

Timely and accurately prepare credential files for audit and submission to assigned facilities

Compliance with standard turn-a-round times

Maintain a working knowledge of relevant regulatory standards (i.e., TJC, AAAHC, DNV and NCQA), state and federal requirements and CMS

Assist with the development and implementation of credentialing and re-credentialing workflows to ensure efficient and effective alignment of processes and assist in the development or revision of credentialing related forms

Participation in special project teams as assigned

Qualification

Credentialing softwareCredentialing verificationCertified Provider Credentialing SpecialistDocumentation skillsEffective communicationTeam collaborationProblem-solvingAttention to detail

Required

High School diploma or GED required

3-5 years related work experience required in CVO or other credentialing setting

Certified Provider Credentialing Specialist (CPCS) required

Experience with computer systems required, including web-based applications and some Microsoft Office applications which may include Outlook, Word, Excel, and credentialing database