New

Credentialing Specialist

Professional Management Enterprises
United States, South Carolina, Columbia
Apr 04, 2025
Seeking a Credentialing Specialistto be responsible for the completion of the initial credentialing and re-credentialing process of providers to the network. Onsite position with potential to go remote. The schedule is M-F 8:00am-4:30pm or 8:30am- 5pm. OT may be required. $17.00/hour Job Essentials: Maintains credentialing database and ensures provider databases are current and accurate. Provides assistance to network staff, providers, contract services, marketing, and medical affairs. Ensures compliance with external review organization standards and delegation agreements. Performs initial and re-credentialing of providers/practitioners including documenting credentialing information. Completes primary verification of state licensure, state/federal controlled substance certification, educational and/or residency background, malpractice coverage/history, hospital privileges, and previous sanctions. Maintains credentialing database and HCS data files with appropriate network indicators and effective dates. Required Education:Associate degree or Two years of related work experience Required Work Experience: 2 years' experience in the healthcare or insurance industry.