Credentialing Specialist

Credentialing Specialist at Meta Sense Inc

Base pay range: $34.00/hr - $34.00/hr.

• Verify credentials for healthcare providers, including licenses, certifications, education, malpractice history, and work experience.
• Ensure compliance with regulatory agencies, hospital standards, and insurance network requirements, maintaining standards from organizations such as The Joint Commission and NCQA.
• Manage enrollment applications for providers with insurance payers and handle hospital privileging processes.
• Maintain accurate credential files and track expiration dates for licenses and certifications.
• Act as liaison between providers, HR, medical staff offices, and payers; communicate with state licensing offices.
• Prepare and maintain reports of credentialing activities; ensure all information meets legal, federal, and state guidelines.
• Process applications for initial and reappointment requests (approximately 125‑200 quarterly).
• Maintain and update provider information in the Echo database and other online credentialing systems.
• Prepare materials and take minutes for Credentials Committee, MEC, and Board of Trustees meetings.
• Attend site‑based medical staff department meetings as needed and collect dues.
• Maintain confidentiality of provider information; perform additional duties as assigned.

• Knowledge of the credentialing process.
• Ability to organize, prioritize, and manage multiple priorities.
• Excellent verbal and written communication skills.
• Strong research, data analysis, and independent work capability.
• Effective relationship‑building skills.
• Excellent computer skills.

Entry level

Contract

Health Care Provider

Hospitals and Health Care