We are looking for a dedicated Credentialing Specialist to support healthcare operations in Richmond, Virginia. This long-term contract position offers the opportunity to apply your expertise in credentialing processes and compliance within the managed care sector. Join a dynamic team where your skills will ensure smooth workflows and adherence to industry standards.<br><br>Responsibilities:<br>• Oversee credentialing and re-credentialing applications for healthcare providers, ensuring compliance with Medicare, Medicare Advantage, and managed care organization standards.<br>• Manage the end-to-end credentialing process, including verifying provider qualifications, certifications, and licensure.<br>• Maintain accurate and up-to-date records in credentialing databases and systems.<br>• Ensure compliance with regulatory requirements and industry standards throughout credentialing workflows.<br>• Collaborate with healthcare providers and internal teams to address credentialing inquiries and resolve issues promptly.<br>• Conduct thorough audits of credentialing applications and documentation to ensure accuracy and completeness.<br>• Stay informed on changes in healthcare regulations and credentialing requirements to adapt processes as needed.<br>• Provide training and guidance to team members on credentialing procedures and best practices.<br>• Support the implementation of process improvements to enhance efficiency and accuracy in credentialing operations.

• Minimum of 3 years of experience in credentialing within managed care organizations.<br>• Expertise in Medicare and Medicare Advantage credentialing protocols and compliance requirements.<br>• Proficiency in handling provider credentialing and re-credentialing applications.<br>• Strong understanding of credentialing processes and healthcare industry regulations.<br>• Exceptional organizational and administrative skills, with attention to detail and accuracy.<br>• Ability to work independently and manage credentialing workflows effectively.<br>• Familiarity with credentialing software and databases.<br>• Strong communication skills to liaise with healthcare providers and internal teams.

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