Credentialing Specialist
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LOUISIANA ORTHOPAEDIC SPECIALISTS LLC
Lafayette, LA, US
Summary
The Credentialing Specialist manages the comprehensive lifecycle of orthopaedic provider credentialing, including initial applications and reappointments. They are responsible for primary source verification, maintaining accurate digital records, and ensuring ongoing compliance with regulatory standards.
Job Description
Description
We are seeking a detail-oriented Credentialing Specialist to join our healthcare team, focusing on orthopaedic provider credentialing. This remote position plays a crucial role in maintaining the highest standards of patient care and regulatory compliance by managing the credentialing process for our orthopaedic healthcare providers.
The Virtual Credentialing Specialist will ensure the accurate verification and maintenance of healthcare provider credentials through:
- Managing the comprehensive credentialing lifecycle for providers, including initial applications, reappointments, and ongoing monitoring of compliance requirements
- Conducting thorough primary source verification of medical education, training, licensure, and board certifications
- Maintaining detailed digital records and updating credentialing databases with precision and timeliness
- Coordinating with insurance payers for provider enrollment and network participation
- Proactively tracking and managing credential renewal deadlines to ensure continuous compliance
- Investigating and resolving credentialing discrepancies through appropriate channels
- Generating regular status reports and compliance updates for leadership review
Requirements
Required Qualifications
- Minimum of 2 years' experience in healthcare credentialing
- Demonstrated proficiency in electronic credentialing management systems
- Strong understanding of healthcare regulations and accreditation standards
- Excellent organizational skills with exceptional attention to detail
Preferred Qualifications
- NAMSS Certification (CPCS or CPMSM)
- Experience with Louisiana State Board of Medical Examiners (LSBME), Louisiana Board of Nursing and Pharmacy
- Demonstrated proficiency with Louisiana Medicaid and MCO credentialing requirements
- Familiarity with the Council for Affordable Quality Healthcare (CAQH)
- Experience with Louisiana hospital privileging systems
- Understanding of Louisiana Workers' Compensation Medical Treatment Guidelines for orthopaedic care
- Familiarity with the Louisiana Uniform Credentialing Program
Acadiana's Leader for Orthopedics, Spine & Sports Medicine!
Louisiana Orthopaedic Specialists has clinics in Lafayette, New Iberia, Scott and Youngsville, LA. Call 337-235-8007 to schedule an appointment with one of our Orthopedic Specialists or 337-889-3106 to reach our Rehabilitation Department. From Foot and Ankle to Hand including Neck, Back, Knee and Shoulder, we have an Orthopedic Specialist who can help you return to activity without pain! We have X-Ray, physical and occupational therapy at all locations along with MRI at our Lafayette clinic.
No referral is necessary - unless required by your insurance.
Louisiana Orthopaedic Specialists is a leader in Robotics for Orthopedic Surgery. Our Fellowship trained specialists offer Robotic Spine (Globus) and Robotic Knee (ROSA and MAKO) for qualified candidates. Ask for Louisiana Orthopaedic Specialists!
Founded
2008
Company size
201-500 employees
Industry
Healthcare
Org type
Partnership
Headquarters
Lafayette, LA
Acadiana's Leader for Orthopedics, Spine & Sports Medicine!
Louisiana Orthopaedic Specialists has clinics in Lafayette, New Iberia, Scott and Youngsville, LA. Call 337-235-8007 to schedule an appointment with one of our Orthopedic Specialists or 337-889-3106 to reach our Rehabilitation Department. From Foot and Ankle to Hand including Neck, Back, Knee and Shoulder, we have an Orthopedic Specialist who can help you return to activity without pain! We have X-Ray, physical and occupational therapy at all locations along with MRI at our Lafayette clinic.
No referral is necessary - unless required by your insurance.
Louisiana Orthopaedic Specialists is a leader in Robotics for Orthopedic Surgery. Our Fellowship trained specialists offer Robotic Spine (Globus) and Robotic Knee (ROSA and MAKO) for qualified candidates. Ask for Louisiana Orthopaedic Specialists!
Founded
2008
Company size
201-500 employees
Industry
Healthcare
Org type
Partnership
Headquarters
Lafayette, LA
