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Credentialing Specialist
3 months ago
The Credentialing Specialist is an integral of the PPE, LLC professional team. Processing candidates and working with the Medical Staff Offices of our sites with a strong knowledge of physician credentialing, Joint Commission regulations and Medical Staff Office procedures and practices is the job of this position.
- Works with recruiter and Clinical Services staff to identify the needs and priorities as they relate to the staffing needs of individuals PPE sites.
- Handles all aspects of new business start-ups (sending offer letters and contracts to incumbents and newly recruited providers, providing HR & Payroll with paperwork to set up providers in our Company system, set up answering service for group, malpractice, etc.)
- Processes newly identified candidates by preparing applications and related paperwork to be sent to the candidate for completion and return.
- Reviews returned application for completion and accuracy and sends completed package to the appropriate Medical Staff Office for processing.
- Maintains accurate candidate information in physician database which is updated regularly with current credentials, address changes, status changes, etc.
- Liaisons with insurance credentialing staff to make sure they have necessary paperwork to credential practitioners with insurance companies for billing.
- Follows up regularly with Medical Staff Offices to assist in the credentialing process of new candidates and supplying any needed information on existing physicians (reappointment applications, updated credentials, etc.)
- Orders scrubs/lab coats and prescription pads for new practitioners as needed.
- Responsible for 24-hour emergency phone coverage for hospital sites.
- Review all payroll at month end before it goes to Payroll dept. for processing.
- Develops and maintains strong working relationships with client hospitals, company medical directors and internal colleagues.
Requirements
- Bachelor’s Degree and/or 2-3 years of hospital credentialing experience required
- Proficiency in MS Word, Excel and Access
- Excellent verbal and written communications skills
- Highly organized, detail oriented
- Ability to multi-task and prioritize is essential
- Must be able to work under pressure and deadlines
- Willing to take on new projects as needed
- Reports to Supervisor of Client Services
