Credentialing Specialist

3 weeks ago

Mount Clemens, United States SVS Vision, Inc. Full time
Job DescriptionJob Description

Since 1974, SVS Vision has helped our customers lead better lives through better vision. As a Michigan-based company with over 80+ offices in 9 states, we have grown to be one of the largest optical companies in the Midwest with the help of our devoted employees. We are a family-oriented company that takes pride in recognizing and rewarding our employees for their hard work and dedication. We trust our company philosophy makes for an exciting and fun work environment where our employees can thrive while providing the best customer service possible. Our pledge to our employees has never wavered, as seen in our remarkable longevity with the opportunities for growth within the company, above-market salaries, and exceptional benefits.

Job Description:

We are seeking a detail-oriented and organized individual to join our team as a Credentialing Specialist. In this role, you will be responsible for ensuring that our healthcare providers meet all necessary qualifications and credentials to provide quality care to our patients. Your primary focus will be on verifying and maintaining accurate provider information, managing the credentialing process, and scheduling operations for Optometrists, and OD Assistants/TO Techs include but are not limited to.

Responsibilities:

  • Conduct thorough verification and review of provider credentials, licenses, certifications, and affiliations to ensure compliance with regulatory requirements and organizational policies.
  • Manage the credentialing process for new and existing healthcare providers, including initial applications, reappointments, and updates.
  • Collaborate with healthcare providers, external credentialing organizations, and other departments, such as human resources and billing to ensure accurate provider information is shared.
  • Maintain accurate and up-to-date provider information in credentialing databases and systems.
  • Monitor and track expiration dates of provider credentials and licenses, and initiate timely renewals.
  • Stay updated on industry regulations, standards, and best practices related to medical credentialing, and ensure compliance within the organization.
  • Assist with audits and inspections related to provider credentialing and compliance.
  • Generate and maintain monthly OD and OD Assistant schedules and time-off requests

Qualifications & Preferred Skills:

  • High school diploma or equivalent required; associate or bachelor's degree in healthcare administration or related field preferred.
  • Proven experience in medical credentialing, preferably in a healthcare setting.
  • Strong knowledge of credentialing processes, regulations, and standards, such as those set by the National Committee for Quality Assurance (NCQA) and the Joint Commission.
  • Familiarity with credentialing software and databases.
  • Excellent attention to detail and ability to work independently with minimal supervision.
  • Strong organizational and time management skills.
  • Excellent communication and interpersonal skills.
  • Ability to handle sensitive and confidential information with professionalism and discretion.

We offer a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated individual with a passion for ensuring quality healthcare, we would love to hear from you.

Benefits and Perks:

  • Affordable medical and dental benefits are available on the 31st day of employment
  • Vision benefits provided by SVS Vision
  • Paid personal & vacation time
  • 401k plan with employer contribution
  • Energetic environment
  • Paid mileage
  • Paid holidays
  • Life and disability insurance
  • Employee assistance program
  • Yearly performance reviews
  • Rewards and recognition for outstanding performance
  • Opportunity for growth and promotions within the company

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