Credentialing Specialist Job at bizjobz LLC, Washington DC

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  • bizjobz LLC
  • Washington DC

Job Description

Credentialing Specialist – Bethesda, MD
Compensation: Base Salary: $52,0000 - $56,000 plus 10% Annual Bonus

Our client, a leading multi-state orthopedic group, is seeking a Credentialing Specialist to support provider credentialing and recredentialing. Reporting to the Credentialing Manager, this role ensures compliance with federal, state, and organizational requirements. On-site presence is required during the first 90 days before transitioning to a hybrid or remote schedule.

Key Responsibilities

  • Manage credentialing and recredentialing applications, ensuring accuracy and compliance.
  • Conduct primary source verification and resolve discrepancies.
  • Maintain accurate provider files and credentialing databases.
  • Submit and update provider rosters with health plans.
  • Prepare verifications and support high-volume processing.
  • Work in EHR systems to resolve credentialing-related account issues.

Qualifications

  • High School Diploma or GED required.
  • 5+ years credentialing experience across all payers.
  • CPCS certification (or actively pursuing).
  • Proficiency with CAQH, Pecos, EMR/EHR systems, and credentialing software (Modio, MDStaff, Intellisoft).
  • Strong Microsoft Office skills with ability to analyze and interpret data.

Job Tags

Work at office,

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