Credentialing Specialist

The Credentialing Specialist is responsible for managing the credentialing and enrollment processes for licensed healthcare providers, including physicians, physician assistants, nurse practitioners, physical therapists, and occupational therapists. Additional responsibilities include enrolling new locations and service lines with insurance carriers, utilizing credentialing software to process applications, and maintaining accurate and up-to-date provider information.

Overview:

The Orthopaedic Center is looking for a highly motivated Credentialing Specialist. This opening is a full-time position averaging 40 hours per week. The Credentialing Specialist is responsible for managing the credentialing and enrollment processes for licensed healthcare providers, including physicians, physician assistants, nurse practitioners, physical therapists, and occupational therapists. This position coordinates hospital privileges, maintains provider licenses and DEA registrations, and ensures timely revalidation and re-enrollment with insurance companies. Additional responsibilities include enrolling new locations and service lines with insurance carriers, utilizing credentialing software to process applications, and maintaining accurate and up-to-date provider information. The Credentialing Specialist will also perform other duties as assigned to support departmental operations and must be able to communicate effectively with patients, TOC physicians and staff.

Qualifications:

Education required: HS/GED

Experience: Two years’ AR/Credentialing experience preferred

Additional Skills/Abilities:

• Proficient with EMR/PM systems, Microsoft Word, Excel, billing software, 10-key, ICD-10 coding, and medical terminology
• Ability to work under pressure, multitask and meet deadlines
• Outstanding organizational, time management and writing skills
• Ability to communicate effectively with patients, physicians and staff
• Self-motivated and ability to work independently
• Independent, self-starting and highly motivated
• Proven positive, "teamwork" attitude in work history

About Us:

At The Orthopaedic Center, we are proud to be the region’s leading orthopaedic group, dedicated to delivering exceptional patient care. As our team continues to grow, we are seeking motivated professionals who are passionate about excellence, collaboration, and making a difference in the lives of our patients. Join our dynamic and expanding organization and become part of a team committed to outstanding orthopaedic care.