Credentialing Specialist – Remote

  • Anywhere

Company Ventra Health, Inc.

Location Remote


Job Summary:
The Credentialing Specialist provides credentialing support for several medical practices to include facility credentialing, payer credentialing, and license/certification renewal. The credentialing specialist will also interact closely with the Client Managers of the practices in meeting credentialing needs. Direct interaction with the providers is anticipated. This person will work with the Credentialing team to meet department goals and will report to the Credentialing Manager.
Essential Functions and Tasks:
Accurately complete credentialing and reappointment applications to be sent to payers and facilities on behalf of providers
Track progress of outstanding applications and report progress to Client Managers/Team Leaders
Work effectively in a team environment
Keep current provider records electronically in Credentialing software, electronic provider folders, and in provider hard copy folders
Assist in obtaining needed documentation from providers, such as copies of state licenses, IRS documents, NPI Notification forms, DEA numbers, board certifications, malpractice certificate of insurance, etc.
Prepare professional communication to providers, payers, and facilities
Understand how provider credentialing impacts billing, contracts, and EDI
Write professional communication to appropriate audience
Ability to learn new software OneApp, OmniForm and IntelliSoft
Complete tasks and projects by deadline
Generate daily reports
Investigate solutions to problems and determine best course of action
Communicate clearly and professionally with team members, providers, payers, facility credentialing representatives, Client Managers, and Team Leaders
Ability to multi task
Proficiency in MS Office
Ability to prioritize and organize
Education and Experience Requirements:
High School diploma or equivalent
Minimum 2 years of credentialing experience preferred
At least one year in data entry field
At least one year in medical billing preferred
Willingness to learn
Knowledge, Skills, and Abilities (KSA’s):
Basic use of computer, telephone, internet, copier, fax, and scanner
Become proficient in use of MedSuite software within 4 weeks
Maintain proficiency in use of Medsuite software
Touch-typing skills, 40 wpm required, 50 wpm preferred
Basic touch 10 key skills
Understand and comply with company policies and procedures
Basic knowledge of Outlook, Word and Excel
Requisition ID: 2022-1318
External Company Name: Ventra Health, Inc.
External Company URL: