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Health Care Credentialing Specialist

Responsible for the credentialing, re-credentialing, and privileging processes for medical providers for Netsmart clients.
Responsibilities
  • Complete provider credentialing and re-credentialing applications; monitor applications and follow-up action as needed.
  • Maintain copies of current state licenses, DEA certificates, malpractice coverage and other required credentialing documents for healthcare providers
  • Track provider license, certification, DEA and professional liability expiration dates to ensure timely renewals.
  • Ensure current health plan and agency credentialing requirements are documented and met
  • Audit and update practice addresses with health plans, agencies and other entities.
  • Process applications for appointment and reappointment of privileges for clients.
  • Maintain client appointment files, and information in credentialing database.
Qualifications
Required
  • High school diploma, GED or equivalent work experience
  • At least 3 years hospital or medical office experience including credentialing.
  • Proficiency in Microsoft Office products, specifically Excel, Word and Outlook
Preferred
  • Bachelor’s degree.
  • At least 1 year of medical billing, cash posting, and/or charge entry work experience.
  • Active Certified Provider Credentialing Specialist (CPCS) certification
Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.
Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart’s third party screening provider.
All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.

To improve the delivery of care to every person in need by utilizing solutions to improve access, cost, efficiency, utilization and outcomes...aiding recovery, supporting prevention and enhancing in quality of life.

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DATE POSTED
July 22, 2023

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