Credentialing Specialist Job at Addison Group, Raleigh, NC

RWdlSWpmclZxUEx2bXVmS2IreWpCUllUbHc9PQ==
  • Addison Group
  • Raleigh, NC

Job Description

Job Title: Credentialing Specialist

Industry: Healthcare

Location: Raleigh, NC

Pay: $24-31/hour

About Our Client:

Addison Group is partnering with a busy and well-respected specialty surgical practice in the Raleigh area to find a dedicated Credentialing Specialist. This role offers the chance to work independently while contributing to a high-performing team focused on excellence in patient care and operations.

Job Description:

We are looking for a Credentialing Specialist to manage all aspects of provider credentialing and enrollment. This role involves maintaining licenses, enrolling providers in Medicare, Medicaid, and commercial payors, securing hospital privileges, and troubleshooting credentialing issues. The ideal candidate will bring a proactive mindset and be comfortable working remotely while communicating effectively with physicians and other stakeholders.

Key Responsibilities:

  • Renew licenses for existing providers and acquire new licenses for incoming providers.
  • Handle provider enrollment with Medicare, Medicaid, and commercial payors.
  • Obtain hospital privileges for physicians and other healthcare providers.
  • Review and address credentialing denials, determining resolutions or communication needs with payors.
  • Maintain and update credentialing databases, including PECOS and CAQH.
  • Collaborate with physicians to gather required documentation and ensure deadlines are met.

Qualifications:

  • 5+ years of credentialing experience, including proficiency with PECOS and CAQH systems.
  • Advanced skills in Microsoft Excel.
  • Familiarity with Athena software is preferred.
  • Strong problem-solving skills with the ability to think independently and take ownership of tasks.
  • High level of integrity and confidentiality in handling sensitive information.

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

IND 004-008

Job Tags

Contract work, Local area,

Similar Jobs

Cornish College of the Arts

Library Assistant Job at Cornish College of the Arts

 ...Starting at $20.76 per hour Position Tasks Working at the circulation desk to assist patrons Using online library systems, checking materials in and out for patrons Placing items on hold for patron pickup Shelving library materials Answering questions... 

Ladgov Corporation

Cleaner Job at Ladgov Corporation

 ...to perform cleaning tasks. Detail-oriented and reliable. Duties: Sweep tile floors and vacuum carpets. Wet mop hard floors and damp mop wax surfaces. Dust horizontal surfaces and clear desks. Empty and clean trash containers, remove trash properly.... 

Gpac

Commercial Roofing Estimator - Remote Job at Gpac

Commercial Roofing Estimator - Remote A reputable contractor is looking for a Commercial Roofing Estimator. The position offers a competitive base salary, robust benefits, and a bonus program. Commercial Roofing Estimator Primary Responsibilities include: Developing... 

Pacific Gas And Electric Company

Utility Worker - General Construction Gas Job at Pacific Gas And Electric Company

 ...Requisition ID# 163288 Job Category: Maintenance / Construction / Operations Job Level: Individual Contributor Business Unit:...  ...weeks of employment. Ability to work extended hours to include nights, weekends and holidays when required. Must possess and... 

Pure Freight Lines, LTD.

Owner Operator/Dry Van Truck Driver Job at Pure Freight Lines, LTD.

 ...Auto and General liability We got you. ~ Minimum of 2 years experience. ~ No forced Dispatch. ~ All No Touch Freight. ~...  ...owned, Illinois-based transportation and logistics company is looking for safety-concious, experienced truck drivers and owner-operators....