Credentialing Specialist

Robert Half

Job Description

Ref ID: 01310-9502940124

Classification: Data Entry Administrator

Compensation: $15.00 to $18.00 hourly

You'll be great as a Credentialing Specialist if you are a data-driven expert with great attention to detail. If you're looking for work on a short-term temporary-to-full-time basis, this position in the Schaumburg, Illinois area might be a good fit. As a Credentialing Specialist candidate you might be interested in this job opening with a growing company in the Healthcare/NHS field. This position is responsible for:

  • Compiles, evaluates, and presents the practitioner-specific data collected for review to management.
  • Analyzes application and supporting documents for completeness and informs the provider of the application status, including the need for any additional information.
  • Performs initial or reappointment/re-credentialing for eligible providers.
  • Processes requests for privileges.
  • Conducts, participates in, and maintains primary source verification.
  • Obtains and evaluates information from primary sources.
  • Recognizes, investigates, and validates discrepancies and adverse information obtained from the application, primary source verification, or other sources.
  • Verifies and documents expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
  • Provides responses to external queries regarding a providers’ status.
  • Applies clearly defined credentialing or privileging processes to all providers.
  • Directs initial or reappointment/re-credentialing processes for eligible providers.
  • Manages provider enrollment.
  • Manages and maintains continuing education records for providers.
  • Completes certification and recertification documents to register dentists as “preferred providers” under the insurance and Medicaid programs.
  • Builds relationships with insurance carriers to facilitate process flow and improvements with providers as requirements change or are added.
  • Assists Billing & Collections Departments to expedite provider enrollment delays that cause claims filing and collection delays.
  • Responds to dental provider inquiries about professional liability insurance coverage and limitations.
  • Address and resolve doctor and insurance company inquiries.
  • Other duties as may arise.

Job Requirements

  • Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, and other office procedures and terminology.
  • Inspires trust and confidence among stakeholders through reliability authenticity, and accountability.
  • Expresses thoughts clearly, concisely and effectively both verbally and in writing. Ensures a free flow of information and communication upward, downward and across the organization by actively listening and encouraging the open expression of ideas and opinions.
  • Displays a credible presence and positive image. Uses appropriate protocol for professional and social situations.
  • Establishes productive, cooperative relationships with subordinates, peers, management, and stakeholders both internal and external to the organization.
  • Applies knowledge, expertise, sound judgment and consults other references and resources as necessary to generate and evaluate solutions and recommendations.
  • Organizes work, sets priorities, and determines short- or long-term goals and strategies to achieve them. Aligns communication, people, processes, and resources to drive success.
  • Displays knowledge of key functions, terminology, and work products of legal, information technology, risk management, and performance concepts.
  • Organizes information and data to identify/explain trends, problems, and their causes. Compares, contrasts, and combines information to determine underlying issues.
  • Ability to work in fast paced environment.
  • Detail oriented. Must be aware of and follow state specific rules and protocols.
  • Active Listening skills. Must be able to give full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate.
  • Deductive Reasoning skills. The ability to apply general rules to specific problems to produce answers that make sense.
  • Time Management Skills to manage one’s own time.
  • The ability to communicate information and ideas in writing so others will understand.
  • Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail.
  • Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.

OfficeTeam, a Robert Half Company, matches professionals in the administrative field with remote or on-site jobs on a temporary and temporary-to-full-time basis. Whether you're a seasoned administrative pro or starting your career, we have options for you.

Our experienced staffing professionals can promote you to employers and advocate on your behalf. We provide access to top jobs, competitive compensation and benefits, and free online training. For more opportunities, get the Robert Half app and receive instant notifications when our AI matches your skills and experience with jobs.

When you work with us, you’re working with the best. has been recognized as one of FORTUNE’s “Most Admired Companies” every year since 1998 and was named to Forbes’ inaugural list of America’s Best Temporary Staffing Firms.

Questions? Call your local office at 1.888.490.4154. All applicants applying for U.S. job openings must be authorized to work in the United States. Benefits are available to temporary professionals. Visit for more information.

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