Senior Credentialing Specialist

Job Description: Purpose - The Junior to Mid Credentialing Specialist supports the accurate and timely credentialing and recredentialing of healthcare providers with insurance networks, clearinghouses, and other credentialing bodies. This role involves assisting the Senior Credentialing Specialist in maintaining compliance, ensuring accurate documentation, and coordinating with insurance networks and other credentialing entities. Key Responsibilities Credentialing and Recredentialing Support: Assist the Senior Credentialing Specialist in preparing, submitting, and tracking provider enrollment applications for insurance networks and credentialing organizations. Ensure the accuracy and completeness of provider credentialing documentation, including licenses, certifications, and insurance coverage. Monitor and update credentialing timelines, ensuring compliance with deadlines and payer requirements. Compliance and Documentation: Perform primary source verifications as directed, maintaining adherence to regulatory and organizational standards. Maintain organized credentialing records and ensure accurate data entry in credentialing software or databases. Assist in audits of credentialing files to verify compliance with HIPAA and other regulatory requirements. Communication and Coordination: Act as a liaison between the Senior Credentialing Specialist, healthcare providers, and external entities to resolve credentialing-related issues. Follow up with providers, payers, and clearing