Credentialing Specialist (15981)

Lake County IL Waukegan , IL 60079

Posted 3 months ago

Do you want a career where you can truly make a difference? The Lake County Health Department and Community Health Center is one of the largest human service providers in Lake County. We live our mission each day, promoting the health and well-being of all who live, work, and play in Lake County. If you are passionate about giving back and ready to be a part of an innovative team, we are looking for you!

About the Role:

The Credentialing Specialist is responsible for coordinating, monitoring, and maintaining the external credentialing and re-credentialing processes for all Lake County Health Department providers and facility site locations as required by external payors including but not limited to Medicare, Medicaid Managed Care Organizations and Insurance Companies.

Location: 3010 Grand Ave, Waukegan, IL

Hours: 20 hours a week. Monday-Friday (10:00am-2:30pm)


Skills and Experience

  • Coordinates the process of gathering all credentialing and re-credentialing materials and submits all required materials to external contacts to initiate and complete the credentialing and re-credentialing cycles.

  • Creates and maintains credentialing files for each provider and location site.

  • Enrolls and maintains active participation in Medicare for LCHD providers and sites

  • Creates, maintains and re-attests CAQH files for each provider.

  • Maintains LCHD credentialing roster(s) and distributes updated roster in a timely manner.

  • Ensures the accuracy and timeliness of the MCO credentialing.

  • Provides project management and administrative support for external credentialing.

  • Assists with the development and implementation of administrative policies and procedures related to credentialing.

  • Maintains the confidentiality of all credentialing information.

Education, Qualifications, and Certification:

  • High School Diploma required, Associates Degree preferred.

  • Experience working in a managed care environment with primary focus on credentialing activities for physicians/facilities is preferred.

  • Working knowledge and understanding of medical insurance industry and managed care organizations.

  • Excellent organizational and communication skills.

  • Above average computer navigation skills with advanced knowledge and experience with Microsoft Office/Outlook, Excel and intra/internet experience.

About the Perks:

Lake County offers a competitive salary and benefit package with performance-based incentive plans. We also offer flexible working hours, and a comprehensive wellness and training program. Visit the Health Department page to get additional information on why you should work for us.

If you would like to learn more about our community impact and to see some of our employees in action, please review this short video.

Any offer of employment is conditioned on the successful completion of a background screening, drug and alcohol testing and may include a pre-employment medical exam. The Lake County Health Department and Community Health Center is an Equal Opportunity Employer.

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Credentialing Specialist (15981)

Lake County IL