Credentialing Specialist

Why Join CEENTA?CEENTA is the premier eye, ear, nose, and throat group in the Carolinas. You'll join a supportive, mission-driven team committed to providing exceptional patient care, ethical healthcare practices, and a collaborative work environment.CEENTA is seeking a highly detail-oriented Credentialing Specialist to support provider enrollment and credentialing processes. This role is vital to ensuring providers are properly credentialed and compliant with all regulatory and payer requirements, helping maintain seamless patient care and operational efficiency.What You Will DoMaintain individual provider files to include up-to-date information needed to complete the required governmental and commercial payer credentialing applicationsMaintain accurate provider profiles on CAQH, NPPES and CMS databasesComplete credentialing applications to add providers to commercial payers, CMS and MedicaidComplete re-credentialing requests issued by government and commercial payersVerify and maintain provider hospital privileges within CredentialStreamEnsures all individual provider locations within the practitioner database match the CEENTA location reportsWork closely with the Business Office to identify and resolve any denials or authorization issues related to credentialingMaintain the provider flu and PPD grids and forward to appropriate staffUpdate and/or provide verification of all payer directories via electronic submission, email (spreadsheets) and/or phoneProvides profile updates/verifications for active and termed CEENTA providers to various facilitiesMaintain internal tracking toolsSubmit reports and respond to inquiriesA Typical DayYou'll spend most of your day managing credentialing data, completing applications, updating provider records, and responding to inquiries.ScheduleFull-time, Remote/hybrid scheduled hours typically fall Monday–Friday, 8:00 a.m. – 5:00 p.m.What You'll BringHigh school diploma or GED, requiredMinimum of 2 years' credentialing experience, highly preferredNAMSS CPSC certification (preferred but not required)Experience with credentialing systemsStrong MS Office skillsDetail-oriented and organizedStrong communication skills#J-18808-Ljbffr

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