Credentialing Specialist

2 weeks ago

Washington, United States TDB Communications, Inc. Full time

The Credentialing Specialist will be responsible for providing credentialing support, to include employment and education verifications, coordination with the customer and provider to ensure onboarding is a successful experience. Your primary responsibility will be to work directly with the provider to collect, verify, and maintain accurate information related to providers' qualifications, licensure, certifications, and other credentials. You will collaborate with internal stakeholders and external entities to ensure compliance with regulatory standards and maintain the highest level of quality assurance.

**Physician Credentialing**: Support credentialing process for providers within the organization, ensuring adherence to industry standards and regulatory requirements.

**Verification and Documentation**: Collect, review, and verify information related to providers' education, training, licensure, certifications, work history, malpractice history, and professional references. Maintain accurate and up-to-date records of all credentials.

**Compliance and Quality Assurance**: Ensure compliance with relevant accreditation standards, government regulations, and internal policies.

**Communication and Collaboration**: Serve as a liaison between providers, internal departments, and external entities to facilitate timely and accurate exchange of credentialing information. Collaborate with medical staff, HR, legal, and other teams to resolve any issues related to provider credentialing.

**Credentialing Database Management**: Utilize credentialing software systems or databases to maintain accurate records, track expirations of credentials, and generate reports as needed.

**Continuous Improvement**: Stay updated on industry trends, best practices, and regulatory changes related to physician credentialing. Participate in process improvement projects to enhance efficiency, accuracy, and overall quality of the credentialing process.

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