Medical Credentials Specialist

6 days ago


GA United States Barbour Orthopaedics Full time
Job Title: Medical Credentials Specialist

Barbour Orthopaedics is seeking a highly skilled Medical Credentials Specialist to join our team. As a key member of our medical staff, you will be responsible for ensuring the accuracy and completeness of physician and provider information, as well as maintaining compliance with regulatory requirements.

Responsibilities:
  • Initial Credentialing: Verify healthcare provider information, conduct background checks, and ensure all regulatory requirements are met.
  • Re-Credentialing: Maintain accurate physician and provider privileging files, ensure all required approvals are received, and grant clinical privileges.
  • Coordination: Work with medical staff personnel to ensure contract providers and allied health professionals are properly licensed and credentialed.
  • Information Collection: Gather data from the National Practitioner Data Bank, applicants, and malpractice insurers.
  • Discrepancy Resolution: Identify discrepancies in information and conduct follow-ups.
  • Communication: Collaborate with healthcare providers and external agencies regarding licensing and credentialing requirements, ensuring ongoing compliance with regulatory guidelines.
Requirements:
  • Education: Bachelor's degree in healthcare administration, business, or a related field (preferred).
  • Experience: 2+ years of credentialing experience with hospital medical staff.
  • Regulatory Knowledge: Experience with state, federal, and accreditation entity regulations and requirements related to credentialing and privileging.
  • Credentialing Knowledge: Knowledge of medical credentialing and privileging procedures, standards, and software.
  • Certification: NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) (preferred).
  • Skills: Strong organizational and analytical skills, with attention to detail, excellent verbal and written communication skills, and proficiency with Microsoft Office.


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