Overview
Credentialing Specialist Jobs in Las Cruces, New Mexico, USA at Community Health Systems
Job Summary
The Credentialing Specialist, under the direction of the Operational Support Services Leadership, maintains administrative rights to all insurance websites so that access requests can be fulfilled for SSC, Hospital, Corporate, and Contracted Vendor associates; request resolution must be completed timely and with outstanding customer service. The position accomplishes this while ensuring Internal Audit Guidelines are being met, guided by Operational Support Leadership and the objectives of the SSC.
Essential Functions
Collects, verifies, and processes healthcare provider credentials to ensure compliance with regulatory and accreditation standards.
Maintains accurate, up-to-date provider files in the credentialing database, tracking changes and expiration dates.
Serves as a liaison between providers, insurance companies, and regulatory bodies, informing them of credentialing status and required updates.
Supports the enrollment of providers with insurance carriers and government programs, ensuring correct setup in networks.
Prepares and maintains reports on credentialing status and assists with audits and accreditation surveys.
Identifies opportunities to improve credentialing workflows and participates in professional development.
Performs other duties as assigned.
Complies with all policies and standards.
Qualifications
H.S. Diploma or GED required
Associate Degree in healthcare administration, business, or a related field preferred
1-2 years experience in healthcare revenue cycle or business office required
2-4 years experience in healthcare revenue cycle or business office preferred
Knowledge, Skills and Abilities
Strong understanding of healthcare credentialing processes, accreditation standards, and regulatory requirements.
Excellent attention to detail and organizational skills.
Strong communication skills (verbal and written), with the ability to interact with healthcare providers, insurance companies, and regulatory agencies.
Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
Problem-solving and critical thinking skills.
Job Info
Job Identification 108315
Job Category Administrative Support
Posting Date 03/05/2025, 03:57 PM
Job Schedule Full time
Job Shift Day
Locations 4351 E Lohman Ave, Las Cruces, NM, 88011, US
#J-18808-Ljbffr
Title: Credentialing Specialist
Company: Community Health Systems
Location: Las Cruces, New Mexico, USA
Category: Healthcare (Healthcare Administration, Healthcare Compliance, Medical Office, Medical Billing and Coding), Administrative/Clerical (Healthcare Administration)
