Credentialing Specialist

Job Description

REQUIREMENTS

• Bachelor’s Degree required
• Demonstrated proficiency with productivity software and project management software (Microsoft Office, G Suite, Asana)
• Database management skills including querying, reporting, and document generation
• Ability to work independently and as part of a team
• Ability to work in a fast paced, expanding organization
• Strong knowledge of the credentialing process and accreditation and regulatory standards. Ability to lead and facilitate processes through influence and collaboration
• Working knowledge of Medical Terminology
• Strong organization and verbal communication skills, attention to details required
• Ability to use independent judgment to manage and impart confidential information
• Demonstrated problem-solving skills and initiative to analyze and disseminate relevant credentialing data across internal company departments
• Ability to make priority determinations without direct supervision
• Preferred: Experience with provider credential databases CAQH, NPPES
• Preferred Experience with JIRA
• Preferred: Experience with HIPAA and compliance-sensitive environments
• Willingness and ability to provide proof of completed COVID-19 vaccination and booster (if eligible), no later than your scheduled start date. If you believe you are entitled to either a medical or religious exemption to our vaccination requirement, please notify your Kyo interviewer immediately so that your situation can be evaluated by Human Resources

RESPONSIBILITIES

• Managing credentialing, recredentialing, and licensure process for clinical staff with health insurance plans, certification boards and other agencies
• Ensuring compliance with various state, federal and payer requirements
• Responsible for pre-application intake, monitoring, application submission and follow up
• Maintaining an efficient and compliant on-boarding process
• Inputing/Updating provider credential databases CAQH and NPPES
• Ongoing monitoring of clinical staff’s credentials to ensure licenses and certifications are current and active
• Working closely with internal departments to exchange provider information and follow up on inconsistencies
• Assisting with other miscellaneous duties in the Revenue and Contracting department

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