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Credentialing Specialist

Medix Mesa Full-Time
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Are you interested in working for one of the fastest growing integrated healthcare systems that is passionate about diversity?

We are hiring for Credentialing Representatives to join one of the leading revenue cycle teams . This credentialing representative will be responsible for credentialing and re-credentialing Q-Point Healthcare client practitioners as well as ensuring enrollment with participating client health plans. They will also be responsible for:

  • Initiate and support the practitioner application process by sending, receiving, and analyzing practitioner documents and data import to determine completeness in preparation for the credentials verification process

  • Responsible for gathering, verifying evaluating highly confidential and sensitive health care practitioner credentials consistent with departmental guidelines and accreditation standards

  • Efficiently perform all aspects of credentialing verification, including initial credentialing and re-credentialing to ensure current credentials and timely handoff and/or review and approval of practitioner files

  • Respond to all practitioner, client health plan and internal inquiries in a timely manner

  • Monitor expiring licensure, board and professional certifications and other expirable documents with practitioners within the prescribed timeframe

  • Maintain practitioner paper and electronic data files for Q Point clients; utilizing EchoOneApp and CAQH to submit practitioner data as required to credential individual practitioners

Minimum Qualifications:

  • 1+ years credentialing experience
  • Experience credentialing for a health plan or clinic-based managed care
  • Understanding of Health Plan + URAC guidelines
  • Use of CAQH
 

Recommended skills

Credentialing
Managed Care
Data Import/Export

Location

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Job ID: 85153

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Launched in 2001, Medix was built on the principle of becoming a leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific and Information Technology industries. As we grow and evolve, we recognize our differentiation lies not just in traditional staffing, but in true partnerships and collaboration on hiring solutions.

We bring value to our talent by helping them identify their individual skills and aptitudes, matching them with opportunities to excel and creating communities where they can foster their skills and always have a trusted partner in their career.

In supporting our clients, we understand that each organization and culture is unique, and we thrive in collaborating with our clients to provide innovative solutions to suit their specific needs.

The root of our growth and continued success stems from not only our loyal clients and talent, but the dedication of our people. Medix takes great pride in our teammates and the culture we built together as an organization. We promote an environment that rewards the hard work and perseverance necessary to solve the unique needs of our clients and talent. The Medix family might span across the country, but our team is tightly united around our core purpose, core values and our mission to provide superior service to our customers.

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