Credentialing Specialist
3 weeks ago
DEPARTMENT:Operations FLSA STATUS: Full-Time; Non-Exempt
SUMMARY
To ensure our business operations goals and client requirements are met, this role is responsible for ensuring that all healthcare providers placed on locum assignments have all internal, client, and other requirements necessary for the assignment completed and active prior to the assignment start date. This person will be responsible for maintaining relationships with providers, clients, third parties, and internal peers by regularly communicating with such individuals via phone and/or email and internal systems to help facilitate the completion of all necessary requirements and related documentation; this includes managing applications, verifications, and all supporting documentation. This person will operate with a sense of urgency, discretion and independent decision making towards problem solving to ensure credentialing is expedited and will be responsible for determining if providers meet the standards/requirements to be placed on client assignments.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Establish and maintain close relationships with clients nationwide and maintain active communication to determine the specific client requirements that need to be completed prior to providers' start dates; work closely with each provider to coordinate completion of required documents for client, CHS, and regulatory/other requirements; instruct on the completion of such documentation
- Review provider documents per established malpractice guidelines to confirm provider eligibility, complete license verifications and reports to verify providers' credentials and past work history
- Obtain required CHS credentialing and privileging needs. Review all medical documentation, certifications, employment forms, testing, background information, competency testing and various other requirements, including references, licensing, and CV documentation to determine whether a provider meets the CHS and client's requirements before starting work. Be familiar with all applicable state and federal requirements
- Obtain all necessary Privileging documents and requirements specified by clients for providers to start assignment on time; provide regular and thorough updates on progress of privileges per assignment to all assigned parties
- Strengthen relationships with clients and build credibility through recommendations of qualified providers
- Coordinate required screenings, including background screening, drug testing, and other medical requirements for providers
- Demonstrate the ability to carry on a business conversation with physicians, hospital executives, medical staff offices, and/or front-office personnel
- Adhere to all company policies, procedures and business ethics codes and ensure that they are communicated and implemented within the team.
- Interface with customer service, sales, and senior level management in communicating and resolving issues.
- Build trust, value others, communicate effectively, drive execution, foster innovation, focus on the customer, collaborate with others, solve problems creatively and demonstrate high integrity.
- Proactively establish and maintain effective working team relationships with all sales and operations departments.
- Minimum Required: 2 or more years of relevant administrative or credentialing experience; high school diploma or GED
- Healthcare Professional operations, staffing, recruiting, or related experience preferred
- Enthusiastic, goal oriented, organized, dedicated, focused, and driven individual
- Demonstrate ability to communicate effectively verbally and in writing, internally and externally
- Demonstrate ability to exercise appropriate discretion in making recommendations
- Demonstrate ability to deliver results and maintain a high level of accountability
- Strong prioritizing, multitasking, project management, organizational and time management skills
- Resourcefulness; proactively seeks out information and resources
- Autonomous; self-directed
- Effective in evolving culture; operates well in ambiguous situations
- Able to prioritize needs among several competing demands
- Will require working outside of business hours to resolve emergency issues should they arise
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