Sandhills Medical Foundation, Inc. is a community health center providing healthcare to anyone regardless of their ability to pay. We are looking to add a Credentialing Specialist to our growing team. The ideal team member is passionate, motivated, detail-oriented, and interested in gaining knowledge and new skills.

Responsibilities:

• Complete provider credentialing and contract applications with third-party carriers and government health plans.
• Review provider credentialing and contracting information to ensure completeness and accuracy.
• Monitor applications and follow up promptly.
• As applicable, document, maintain and crosscheck client credentials in multiple databases, including CAQH and other third-party databases.
• Collaborate with SC Primary Care Association on credentialing of providers.
• Create, update and track provider information in the internal credentialing system to ensure that credentials are completed timely and correctly.
• Maintain contact logs documenting requests for credentialing information in designated systems.
• Meet or exceed all deadline requirements for provider communications, enrollments, and follow-ups.
• Report to management any unresolved issues or missing information that is creating a delay in processing.
• Receive and respond to client inquiries via phone and email.
• Establish and preserve quality working relationships with internal and external customers, utilizing excellent customer service skills to solidify relationships.
• Communicate carrier updates and changes in policies as emerging and ascertained.

Qualifications:

• 1-3 years of experience in credentialing and contracting.
• Knowledge of Commercial Insurance and Government Payor guidelines.
• Ability to access multiple databases and sites at the same time.
• Ability to work within deadlines and facilitate workflow with minimal supervision.
• Ability to plan, organize, and complete work with competing priorities.
• Organized and detail-oriented.
• Good communication, problem-solving, and follow-up skills.
• Maintains excellent communication with direct supervisor, routinely advising of credentialing and contracting statuses.

Benefits

• 401(k)
• 401(k) Matching
• Dental Insurance
• Health Insurance
• Paid Time Off
• Vision Insurance

Sandhills Medical Foundation, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors.

Job Type: Full-time

Pay: $17.00 - $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Supplemental pay types:

• Bonus pay

People with a criminal record are encouraged to apply

Ability to commute/relocate:

• Camden, SC 29020: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Credentialing: 1 year (Preferred)

Work Location: One location

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