Credentialing Specialist

1 month ago

Miami, United States Medrina Full time
Job DescriptionJob Description

Job Summary:

The Credentialing Specialist is responsible for credentialing medical providers along with maintaining relationships with Medical Staff offices and reports to the director. The Specialist will collaborate with providers to ensure provider is credentialed as quickly as possible with accuracy and completeness. This is a full-time remote position working from eastern or central time zone.

Duties/Responsibilities:

  • Responsible for credentialing and recredentialing of medical providers directly with each hospital.
  • Performs primary source verification for initial credentialing and recredentialing.
  • Maintains credentialing database and files, including supporting documentation.
  • Works closely with clinical staff to obtain data, documents, and signatures, as needed, in a timely and secure manner.
  • Meets regularly with Medical Staff office to track progress of files throughout each hospital’s process.
  • When new program contracts are signed, or if we are changing staffing models and several applicants will be requesting privileges for a hospital, the credentialing specialist will report progress and barriers on weekly implementation call.
  • Guides providers through the process of collecting documentation and supports them to resolve outstanding items for their file.
  • Tracks expirable and provides updated documentation to the medical staff offices and uploads new documents into the credentialing database.
  • Performs other duties and responsibilities as required, assigned, or requested.
  • Leads discovery sessions with medical staff offices to understand and document each new hospital’s process. This includes gathering information on how they process the files, timing of their credentialing committee meetings, methods for accepting dues and fees along with how they verify they have received them, and what terminology they use to identify a provider is ready to be sent to committees.

Requirements:

  • High School Diploma and an associate’s degree in health services administration or related field.
  • Certified Provider Credentialing Specialist (CPCS) certification or Certified Credentialing Specialist (CCS) certification.
  • Minimum 2 years of experience in credentialing physicians for hospitals.
  • Experience and proficiency with general computer software (Word, Excel, PowerPoint, PDF, Outlook, credentialing software)
  • Ability to maintain effective interpersonal relationships.
  • Ability to communicate effectively in both oral and written form with physicians and external partners.
  • Skilled in completing assignments accurately and with attention to detail.
  • Ability to independently plan, organize and prioritize work.

Physical Requirements:

  • Prolonged periods of sitting at a desk.
  • Must be able to lift up to 15 pounds at times.

EOE/M/F/Vet/Disability

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

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