Credentialing Specialist
6 days ago
This role is responsible for processing applications from physicians for medical staff appointment, clinical privileges, and reappointment to the SRALAB Medical Staff. The successful candidate will also manage credentialing with managed care companies and obtain Medicare/Medicaid/IDPH provider numbers for physicians, nurse practitioners, and select allied health staff members.
Key Responsibilities- Distribute applications and establish electronic database files for medical staff members
- Analyze information for discrepancies, misstatements, missing data, and time gaps
- Perform primary source verification of information contained in applications
- Discuss key issues and problems with the Credentials Committee and Senior VP for Medical Affairs
- Maintain accurate and current credentialing databases for medical staff members
- Monitor physicians' license and insurance expirations with potential high-risk exposure for SRALAB
- Act as liaison person for managed care credentialing
- Process applications for Medicare/Medicaid/IDPH provider numbers
- Collect dues from Active Medical Staff and prepare quarterly treasurer's reports
- Assure compliance with accreditation standards and regulatory guidelines
- Work requires secretarial skills normally acquired through six months or less of formal training, plus two years of college
- Work requires two to three years of progressively more responsible clerical or secretarial experience and the ability to exercise independent judgment
- Interpersonal skills needed to interact with key managerial personnel within the hospital and peers within the medical community
- Excellent analytical ability needed to prepare reports and documents and to maintain various administrative records
- Proficient computer skills and knowledge of Windows and Word for Windows
Normal office environment with little or no exposure to dust or extreme temperature.
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