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Credentialing Specialist (47605)

CHARLOTTE EYE EAR NOSE AND THROAT ASSOCIATES PA
Posted 3 months ago, valid for 10 days
Location

Charlotte, NC 28281, US

Salary

Competitive

Contract type

Full Time

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Sonic Summary

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  • CEENTA is hiring a Credentialing Specialist to support provider enrollment and credentialing processes in Charlotte, NC.
  • The position requires a minimum of 2 years of credentialing experience, with a high school diploma or GED as a prerequisite.
  • The role involves maintaining provider files, completing applications for various payers, and ensuring compliance with regulatory requirements.
  • This is a full-time remote/hybrid position with a typical schedule from Monday to Friday, 8:00 a.m. to 5:00 p.m.
  • Salary details are not provided in the job description.

Job DetailsJob Location: SouthPark, Corporate - Charlotte, NC 28210Why 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 Do Maintain individual provider files to include up-to-date information needed to complete the required governmental and commercial payer credentialing applications Maintain accurate provider profiles on CAQH, NPPES and CMS databases Complete credentialing applications to add providers to commercial payers, CMS and Medicaid Complete re-credentialing requests issued by government and commercial payers Verify and maintain provider hospital privileges within CredentialStream Ensures all individual provider locations within the practitioner database match the CEENTA location reports Work closely with the Business Office to identify and resolve any denials or authorization issues related to credentialing Maintain the provider flu and PPD grids and forward to appropriate staff Update and/or provide verification of all payer directories via electronic submission, email (spreadsheets) and/or phone Provides profile updates/verifications for active and termed CEENTA providers to various facilities Maintain internal tracking tools Submit reports and respond to inquiries   A Typical Day You’ll spend most of your day managing credentialing data, completing applications, updating provider records, and responding to inquiries.   Schedule Full-time, Remote/hybrid scheduled hours typically fall Monday–Friday, 8:00 a.m. – 5:00 p.m. QualificationsWhat You’ll Bring High school diploma or GED, required Minimum of 2 years’ credentialing experience, highly preferred NAMSS CPSC certification (preferred but not required) Experience with credentialing systems Strong MS Office skills Detail-oriented and organized Strong communication skills




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