Credentialing Specialist Job - Bloomington, MN

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Credentialing Specialist
The Credentialing Coordinator will organize, maintain and verify all aspects of the process, and maintain current files on practitioners. They will track the expiration of certifications to maintain up-to-date files, and assist health plan providers and customers with phone inquiries. To be successful in this role you should ensure the currency and accuracy of all information. Preferred candidates will be reliable, energetic and have excellent people skills.
Essential Duties and Responsibilities
  • Coordinate credentialing of new providers, and re-credentialing of existing providers.
  • Review and process incoming provider and CRNA applications. Follow up on any information that is missing or incomplete.
  • Maintain credentialing database to ensure information is current and accurate including but not limited to; provider numbers, education, licensure, certifications, COI and privileges.
  • Communicate with staff and providers regarding ongoing compliance with licensing and credentialing needs in a proactive and timely manner.
  • Ensure compliance with applicable laws, regulations, procedures and policies.
Education/Experience Required
  • High school diploma, GED or suitable equivalent
  • 2+ years credentialing experience
  • Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Manager (CPMSM) preferred.
EEO Employer: Women, Minorities, and the Disabled are encouraged to apply.
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