Credentialing Specialist | OrthoArizona
Overview
Lead credentialing operations for medical providers ensuring accurate onboarding and timely re-credentialing. Manage Medicare AHCCCS and commercial payor processes while collaborating with leadership to maintain compliance and efficiency. Drive improvements in documentation accuracy and timeliness.
What You'll Do11
- 1Process credentialing and recredentialing applications for medical providers and organizations
- 2Prepare weekly reports for division administrators and providers
- 3Follow OrthoArizona federal and state credentialing requirements
- 4Assist with routine audits to verify reimbursement alignment
- 5Prioritize tasks to meet deadlines with precision
- 6Submit required documents on schedule and manage follow-ups
- 7Promote positive teamwork and workplace culture
- 8Work independently while multitasking across diverse responsibilities
- 9Communicate effectively with employees providers and health plans
- 10Maintain strict confidentiality of sensitive information
- 11Update provider profiles using NPI and CAQH systems
Requirements6
- 1Strong working knowledge of Medicare and commercial payor credentialing standards
- 2Proficiency with PECOS and AHCCCS platforms
- 3High skill level in Microsoft Office applications
- 4Minimum 3 years experience in Medicare AHCCCS and commercial payor credentialing
- 5Familiarity with credentialing software and NCQA requirements
- 6High School Diploma or equivalent
Salary Insight
Salary not disclosed in listing
Location
Required Skills
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