Job Description

Job Title: Credentialing Specialist

Industry: Healthcare

Location: Raleigh, NC

Pay: $24-31/hour

About Our Client:

Addison Group is partnering with a busy and well-respected specialty surgical practice in the Raleigh area to find a dedicated Credentialing Specialist. This role offers the chance to work independently while contributing to a high-performing team focused on excellence in patient care and operations.

Job Description:

We are looking for a Credentialing Specialist to manage all aspects of provider credentialing and enrollment. This role involves maintaining licenses, enrolling providers in Medicare, Medicaid, and commercial payors, securing hospital privileges, and troubleshooting credentialing issues. The ideal candidate will bring a proactive mindset and be comfortable working remotely while communicating effectively with physicians and other stakeholders.

Key Responsibilities:

• Renew licenses for existing providers and acquire new licenses for incoming providers.
• Handle provider enrollment with Medicare, Medicaid, and commercial payors.
• Obtain hospital privileges for physicians and other healthcare providers.
• Review and address credentialing denials, determining resolutions or communication needs with payors.
• Maintain and update credentialing databases, including PECOS and CAQH.
• Collaborate with physicians to gather required documentation and ensure deadlines are met.

Qualifications:

• 5+ years of credentialing experience, including proficiency with PECOS and CAQH systems.
• Advanced skills in Microsoft Excel.
• Familiarity with Athena software is preferred.
• Strong problem-solving skills with the ability to think independently and take ownership of tasks.
• High level of integrity and confidentiality in handling sensitive information.

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

IND 004-008

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