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Medical Credentialing Specialist
3 months ago
Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery.
Because of our exciting growth, we are hiring a Medical Credentialing Specialist. The Credentialing Specialist is responsible for partnering with medical providers, hospitals, insurance companies, operations leaders, and other stakeholders to ensure providers are credentialed.
Essential Duties:
- Stay abreast of credentialing and recredentialing requirements for each client group
- Requests, reviews, and verifies credentialing applications and supporting documentation
- Establish and maintain database of provider details and credentialing data
- Monitor license and certification expirations for providers to ensure timely renewals
- Notify providers and administration of upcoming expirations and documentation requests
- Collaborate with hospitals, insurance companies, and other stakeholders to extend information and track credentialing process
- Provide status updates to operations leaders, providers, and other stakeholders
- Resolve issues that arise and escalate when appropriate
- Other duties as assigned
Skills, Knowledge, Abilities:
- Knowledgeable on credentialing requirements and workflows for providers at differing client groups
- Familiar with healthcare jargon and terminology related to credentialing
- Excellent verbal and written communication skills
- Excellent interpersonal and customer service skills
- Proficient in Microsoft Office and credentialing related software
- Excellent organizational skills and attention to detail
- Work independently and exercise judgement on decision making and issue resolution
- Navigate competing priorities and effectively work in a fast-paced environment
- Manage information flow in a timely and accurate manner
- Collaborate with an array of professionals at various client groups and geographic locations
- Identify and execute opportunities for improvement
- Exhibit growth mindset and team-orientated behaviors
Experience:
- Prior administrative experience in a healthcare environment
- Medical credentialing experience preferred
- Experience with MS Outlook, Word, and Excel
- Experience with MS Teams and credentialing software preferred