Credentialing Specialist Jobs

Who We Are

With a mission to provide world-class healthcare to the underserved Asian community, Rendr is the leading primary care focused, multi-specialty physician group dedicated to serving the Asian population in New York City. Our over 200 providers take care of the health of approximately 200,000 patients at more than 100 clinical offices throughout Brooklyn, Manhattan, Queens, Staten Island and Nassau County.

Department: Credentialing

Location: Headquarters

Position: Credentialing Specialist

Reports to: Credentialing Manager

Essential Functions

· Complete primary source verification for delegated payer contracts

· Prepare audited credentialing files for Committee Review

· Track provider updates and changes in accordance with all payer credentialing guidelines and NCQA standards

· Prepare re-credentialing or updated provider files for credentialing committee review

· Manage continuing education & training requirements from state and payers, in coordination with operations and human resources

· Track hospital affiliations and ensure provider completes necessary updates and renewals

· Review and update as needed, each assigned providers CAQH profile within the 90-day timeframe

· Maintain working knowledge and ensure compliance with all payer requirements for documentation and credentialing standards

· Primary payor contact, ensure all communications are initiated and responded to timely

· Tracking and reporting all data and updates into applicable software / databases etc.

· Assist providers, site staff, and revenue cycle management team with any issues pertaining to credentialing and provider payer enrollment

· Participates in Health Plan meetings, as needed.

· Perform other duties and special projects as requested by Credentialing Manager

Qualifications

· Bachelor’s degree

· 4+ years related credentialing experience in a healthcare setting

· Ability to manage competing priorities

· Excellent time management and organizational skills

· Strong interpersonal skills with ability to work effectively with clinical leadership and site operations

· Ability to work in a fast-paced environment

Benefits

• Medical, vision, dental and life insurance
• Short and Long-Term Disability
• 401k Plan with Match
• A friendly and fast-paced environment working with passionate people
• A Comprehensive Benefits Package
• PTO and Paid Holidays
• Competitive pay