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Credentialing Specialist

bronx, ny • Posted 5 days ago
Onsite Full Time General

Credentialing SpecialistThe Credentialing Specialist is responsible to coordinate and assist with the day-to-day administrative functions of the Department. The selected candidate will have excellent written communication skills, able to multitask and manage time effectively and provide administrative support to the Delegation team within the Credentialing Department.ResponsibilitiesKey Responsibilities:Efficient and timely completion of confidential Medicaid applications for provider enrollment, group affiliations, and ETIN enrollment/ maintenance.Follow established timelines for processing and completion of applicationsCritically evaluate application for any issues that may require special consideration, or additional review, and take appropriate action to resolve issueIdentify providers whom are due for ETIN recertification and escalate to supervisor appropriatelyCoordinate with appropriate credentialing onboarding staff to obtain required information from providerPerform self-audit of work to ensure data integrity before mailing applicationsDocument all tasks, phone calls, emails and other forms of communication during the application process.Update rest of Medicaid team and onboarding platform once mailedAssist to track the status of mailed applications, if neededProvide status updates to Credentialing Department's leadership within one business day, from receipt of requestWork with supervisor in identifying back-up coverage when out of the officeTimely and complete updates of credentialing softwareComplete other related tasks or projects as assignedProvide back-up to other Credentialing staff as necessaryEnsure providers files have up to date forms for Medicaid revalidations and yearly certifications.Communicate with all levels of organization to obtain documentation and signatures.QualificationsCompetencies:Able to multitask, prioritize, and manage time efficientlyExcellent verbal and written communication skillsStrong interpersonal and communication skills with an ability to work effectively with a wide range of people, teams, managers, supervisors, and vendors.Proficient with MS Office (outlook, word, excel, power point, access)Qualifications:Bachelor's Degree in a Health-Related Discipline: Public Health, Healthcare Administrative, Health Service, Psychology or Sociology Highly Preferred, or in processHigh School Diploma RequiredHands on experience supporting healthcare credentialing and enrollment functions preferredNotary a plusEqual Opportunity EmployerESSEN HEALTH CARE IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYEREssen Healthcare is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically-diverse population.

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