We are seeking a detail-oriented and experienced Credentialing Administrator to join our dermatology practice. The Credentialing Administrator will be responsible for managing and maintaining the credentialing and re-credentialing process for all healthcare providers, ensuring compliance with regulatory and insurance requirements. The ideal candidate will have a strong understanding of credentialing procedures, excellent organizational skills, and the ability to communicate effectively with providers, payers, and internal staff.

Key Responsibilities:

• Oversee      and manage the credentialing and re-credentialing processes for      physicians, nurse practitioners, and other healthcare providers within the      practice.
• Maintain      up-to-date provider files, ensuring all documentation is current and      compliant with federal, state, and payer-specific requirements.
• Prepare      and submit applications for provider enrollment with commercial and      government insurance plans (Medicare, Medicaid, private insurers, etc.).
• Track      and monitor the status of credentialing applications, following up as      needed to ensure timely approvals.
• Maintain      credentialing databases and software, updating records as necessary.
• Coordinate      with providers and practice administrators to ensure timely submission of      required documentation.
• Monitor      and ensure compliance with regulatory bodies, such as The Joint Commission      (TJC), National Committee for Quality Assurance (NCQA), and the Centers      for Medicare & Medicaid Services (CMS).
• Respond      to inquiries regarding credentialing status and requirements.
• Assist      in audits and provide reports on credentialing activities as needed.

Qualifications:

• Associate’s      or Bachelor’s degree in healthcare administration, business      administration, or a related field (preferred).
• Minimum      of 2-3 years of experience in medical credentialing, preferably in      a Dermatology or multi-specialty practice.
• Knowledge      of provider enrollment procedures with Medicare, and commercial payers.
• Familiarity      with credentialing databases and software systems.
• Strong      understanding of compliance regulations and industry standards.
• Excellent      attention to detail and organizational skills.
• Strong      communication and problem-solving abilities.
• Ability      to work independently and manage multiple tasks efficiently.

Benefits:

• Competitive      salary based on experience.
• Health,      dental, and vision insurance.
• Paid      time off and holidays.
• Professional      development opportunities.
• Retirement      plan options.

If you are a highly motivated professional with a passion for ensuring provider compliance and a commitment to excellence, we invite you to apply for this position. Please submit your resume along with a cover letter.