Medical Credentialing Specialist

1 month ago


Lafayette, United States Core Clinical Management LLC Full time
Job DescriptionJob DescriptionDescription:

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


Requirements:

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


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