• Lynbrook, NY, USA
  • Hourly
  • Full Time

Health, Dental, Vision, 401K, Life Insurance, PTO


Position Purpose:

  • The Credentialing Specialist role at our Newport Credentialing Solutions division performs a critical role in ensuring healthcare physician credentialing and re-credentialing is done in an expedient manner with excellent attention to detail

Education & Experience:

  • Minimum 2-4 years of provider credentialing / enrollment experience preferred
  • Minimum 2-year college degree preferred
  • Prior data management / data integrity experience preferred

Licenses & Certifications Desired:

  • None

Competencies & Work Style:

  • Highly self-motivated, preferably with some expertise in the healthcare physician credentialing, expirables management, re-credentialing, provider enrollment environment, or medical industry in general
  • Success-driven and results-oriented, with the ability to implement and manage cross-functional projects
  • Proficiency with credentialing systems and learns new systems/processes quickly
  • Ability to interact effectively with a variety of people (such as physicians and medical staff offices)
  • Provides highest level of customer service for both internal and external customers
  • Strong written and verbal communication skills, along with strong presentation and client interaction skills
  • Ability to prioritize tasks and projects
  • Accurate discernment on when to act independently and when to ask for guidance and/or assistance
  • Consistently demonstrates flexibility, a customer-focus, terrific organizational skills and a passion for details


Responsibilities & Essential Functions:

  • Coordinate all managed care credentialing activities to ensure provider participation status; credentialing activities require substantial contact with outside agencies
  • Prepare credentialing and re-credentialing applications on behalf of providers for submission to managed care companies and other agencies
  • Maintain necessary logs, lists, records, and current documentation required for provider credentialing and re-credentialing
  • Verify physician/provider information for managed care plans including communication with health plan representatives and other staff as necessary
  • Follow-up with managed care companies to ensure expedient credentialing
  • Prepare and complete applications, link letters and spreadsheets to managed care organization specifications
  • Maintain relationships with external managed care organization and clients as required
  • Other duties as assigned


Work Environment & Physical Demands:

  • This is a largely sedentary role; however some filing is required, which would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary
  • This job operates in a clerical, office setting
  • This role routinely uses standard office equipment such as computers, phones, copiers, filing cabinets and fax machines. 
  • This position does not require travel
  • This is a full-time, 40-hour per week position, and typical work hours are Monday through Friday 8 a.m. to 5 p.m. although project support may require temporary adjustments to those hours only as needed
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