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Credentialing Specialist

A-Line Staffing Solutions Bedford, NH

  • Expired: over a month ago. Applications are no longer accepted.
Job Description

A Credentialing Specialist is needed for a major managed care company in Bedford, NH!

** Must be local to Bedford, NH (Remote to start) **

Position Purpose: Perform provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of data via internet sites and other systems, and usage of multiple systems and applications to validate data is complete and accurate.


Summary of Job Duties:

Create contracts and manage the contracting process for new business opportunities, prepare contract status and metric reporting, identify gaps and risks in contracting process, and assist with work assignments.

  • Assist with the contract submission process and the auditing of provider information systems for consistency and best practices in Provider set up.


Hourly Rate: $20 hourly

Hours: 8am - 5pm Mon-Fri


Required Skills:

  • 1+ years of data entry, analysis or customer service experience, preferably with healthcare operations (i.e., claims processing, billing, provider relations or contracting), provider data management, or credentialing in a managed care, insurance, or medical office environment.
  • Experience performing data analysis in Excel or similar tools strongly preferred.
  • High School diploma or GED required.

Preferred Experience:

  • 3+ years’ experience in Medicaid and Medicare with Provider data. (i.e.  provider relations, credentialing, provider contracting, claims processing, claims research, or provider maintenance environment; can be in a health plan environment or healthcare/medical office environment)
  • College level coursework and/or Associate’s Degree


Why Apply:

  • Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
  • 401k after 1 year of employment: With employer match and profit sharing
  • GREAT Hours! Monday through Friday, 40 hours per week
  • Competitive Pay Rate!


Keywords: Provider Data, Provider Services, Provider Enrollment, Credentialing, Claims Processing, Referrals, Healthcare Call Center, Customer Service, Claims, Benefit Verifications, Medical Billing, Medical Coding, ICD-9, ICD-10, CPT, CPC, Billing & Coding, Appeals, Grievances, Denials, Managed Care, Health Plan, Health Insurance, Case Manager, Care Manager, Utilization Review, Utilization Management, STARS, HEDIS, Complex Case Management, CCM, Certified Case Manager, NCQA, URAC, CMS, Medicare, Medicaid, HMO, Quality Assurance, Quality Improvement.

A-Line Staffing Solutions

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Bedford, NH
03110 USA




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