Now in network with BCBS and Cigna.


  • Completing and processing provider credentialing applications
  • · Maintains current and accurate credentialing/privileging files for all licensed independent practitioners
  • · Maintaining knowledge of current health plan and agency requirements for credentialing providers
  • · Providing credentialing and privileging verifications if applicable
  • · Notifies manage care plans of all terminations and demographic changes for all licensed individual practitioners (LIPs)
  • · Audit managed care plans on a monthly basis to ensure that all LIPs are accurately enrolled with all appropriate practice locations
  • · Complies and maintains accurate monthly reports/rosters of all enrolled/credentialed practitioners; confirming all providers are appropriately enrolled with the correct managed care plans
  • Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day to day credentialing and privileging issues as they arise
  • Assists with managed care delegated credentialing audits; conducts internal file audits
  • Utilizes the credentialing database, optimizing efficiency and performs query, report and document generation
  • Assists in the implementation and maintenance of processes and procedures including regulatory certification guidelines related to physician credentialing


  • 1-2 years of current and relevant credentialing experience, knowledge of medical credentialing and privileging procedures and standards
  • Ability to efficiently and effectively manage multiple tasks to prioritize needs and meet deadlines
  • Strong attention to detail
  • Sound written and verbal communication skills
  • Ability to maintain confidentiality of information and exercise good judgment and discretion in handling and disseminating information
  • Ability to research and analyze data and to work independently with minimal supervision

Unleash Your Natural Beauty

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