认证专员
Credentialing Specialist
职位名称：马里兰州医疗提供者认证专员
公司：Elevate Calls Inc.
地点：远程（永久居家办公职位）
职位概述
Elevate Calls Inc. 正在寻找一名具有马里兰州医疗认证经验的认证专员加入我们不断壮大的远程团队。在此职位中，您将负责马里兰州医疗提供者的认证和注册流程。您的工作对于确保符合州和联邦法规以及特定付款人要求至关重要。
主要职责
- 管理马里兰州医疗提供者的认证和重新认证流程，包括医生、护士执业者和相关健康专业人员。
- 确保所有提供者文件符合马里兰州州法规、保险指南和国家认证标准。
- 完成并提交认证申请和注册表格给商业付款人、医疗补助和医疗保险（通过 PECOS）。
- 在认证系统如 CAQH、NPPES 和内部数据库中维护和更新提供者数据。
- 跟踪和监控到期事项，如执照、认证和重新认证截止日期。
- 与保险公司、政府机构和内部部门进行专业沟通，解决认证相关问题。
- 及时了解马里兰州付款人要求、认证法规和医疗保健规定。
- 进行背景调查，验证资质，并保持准确完整的提供者档案。
任职要求
- 具有医疗认证或提供者注册经验，最好有马里兰州提供者经验。
- 熟悉马里兰州特定的认证标准，包括马里兰州医疗补助和区域付款人（例如 CareFirst、Maryland Physicians Care）。
- 熟练使用认证平台，如 CAQH、PECOS 和 NPPES。
- 熟悉 EPREP 门户（马里兰州应急准备与响应门户），包括提供者注册和合规功能。
- 极强的细节关注能力和有效管理多个截止日期的能力。
- 出色的书面和口头沟通能力；与内部和外部利益相关者互动专业。
- 在完全远程的工作环境中自我驱动且可靠。
- 展现出对保密性和遵守医疗保健法规的承诺。
- 如何申请
- 如果您是积极进取的认证专员
查看英文原文
Job Title: Credentialing Specialist Maryland Healthcare Providers
Company: Elevate Calls Inc.
Location: Remote (Permanent Work From Home Position)
Position Overview
Elevate Calls Inc. is seeking a Credentialing Specialist with experience in Maryland healthcare credentialing to join our growing remote team. In this role, you will oversee the credentialing and enrollment processes for healthcare providers practicing in Maryland. Your work will be essential in ensuring compliance with state and federal regulations, as well as specific payer requirements.
Key Responsibilities
- Manage the credentialing and recredentialing processes for Maryland-based healthcare providers, including physicians, nurse practitioners, and allied health professionals.
- Ensure all provider files comply with Maryland state regulations, insurance guidelines, and national accreditation standards.
- Complete and submit credentialing applications and enrollment forms to commercial payers, Medicaid, and Medicare (via PECOS).
- Maintain and update provider data in credentialing systems such as CAQH, NPPES, and internal databases.
- Track and monitor expirable items such as licenses, certifications, and recredentialing deadlines.
- Communicate professionally with insurance companies, government agencies, and internal departments to resolve credentialing-related issues.
- Stay up to date with Maryland payer requirements, credentialing laws, and healthcare regulations.
- Conduct background checks, verify credentials, and maintain accurate, complete provider profiles.
Qualifications
- Prior experience in healthcare credentialing or provider enrollment, preferably with Maryland-based providers.
- Familiarity with Maryland-specific credentialing standards, including Maryland Medicaid and regional payers (e.g., CareFirst, Maryland Physicians Care).
- Proficiency with credentialing platforms such as CAQH, PECOS, and NPPES.
- Familiarity with the EPREP Portal (Maryland Emergency Preparedness and Response Portal), including provider registration and compliance functions.
- Exceptional attention to detail and the ability to manage multiple deadlines effectively.
- Strong written and verbal communication skills; professional in interactions with both internal and external stakeholders.
- Self-motivated and reliable in a fully remote work environment.
- Demonstrated commitment to confidentiality and compliance with healthcare regulations.
How to Apply
If you are a motivated credentialing professional with experience in Maryland healthcare, wed love to hear from you. Please send your resume to with the subject line:
Credentialing Specialist Maryland
We look forward to reviewing your application!
Industry
· Business Consulting and Services
Employment Type
Full-time
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Originally posted on Himalayas