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Credentialing Specialist

St.Petersburg, FL 33701 | Fully Remote

Posted: 07/08/2024 Employment Type: Direct Hire Job Category: Administrative/Clerical Job Number: 20063 Earning Potential: $55-$70k yearly

Job Description

Credentialing Specialist
Location: St. Petersburg, Florida 33701 
Pay: $55-$70k yearly, depending upon experience
Type:  Direct hire or contract to hire, depending upon experience
Job description:
•    Manage the credentialing process for 60-80+ licensed Medicare Agents, verify licenses, appointments with carriers, and required CE coursework and certifications for maintaining licenses.  
•    Track, organize, and process documentation and activities pertaining to the organization’s contractual arrangements, ensuring accuracy and adherence to timelines.
•    Conduct credentialing processes, including for Medicare following industry-standard practices and regulatory guidelines.
•    Communicate effectively with internal and external stakeholders regarding compliance requirements, providing necessary support and coordinating audit schedules.
•    Initiate and manage the credentialing process with Medicare Advantage plans and other relevant entities, ensuring all necessary documentation is submitted and reviewed promptly.
•    Monitor the progress of credentialing applications for each agent, proactively identifying and resolving issues to facilitate timely completion.
•    Receive, review, and evaluate initial applications from prospective agents, verifying licensure, certifications, and other credentials as required.
•    Ensure completeness and accuracy of all application materials and documentation, maintaining meticulous records of credentialing activities and ensuring accessibility for audits and reporting purposes.
•    Minimum 3 years' recent experience reviewing contracts and handling credentialing processes coming from a healthcare background.
•    High school diploma or equivalent.
•    Background check required.

Meet Your Recruiter

Michelle Louden
Senior Director of Client Services

Hi, I’m Michelle, Senior Director of Client Services.  I look forward to connecting with you on your job search.

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