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Medical Staff Credentialing Coordinator

1 month ago

Brentwood, Tennessee, United States Ovation Healthcare Full time
About Ovation Healthcare

Ovation Healthcare is a leading provider of healthcare services, dedicated to strengthening independent community healthcare. Our mission is to support hospitals and health systems with the expertise and resources needed to thrive in a rapidly changing healthcare landscape.

We're seeking a talented Credentialing Specialist to join our team. As a key member of our operations team, you will play a critical role in ensuring the accuracy and completeness of medical staff credentials and licenses.

Key Responsibilities

Monitor and maintain compliance with regulatory and accrediting institutions
Verify and update staff credentials and licenses
Advise staff on renewal procedures and requirements
Develop and implement internal credentialing processes
Manage and maintain records of licenses, credentials, and insurance contracts
Release information to agencies and members of the public as required by law
Evaluate and verify new credentialing packets
Input provider demographics into the credentialing database system
Complete and submit enrollments with insurance carriers
Track and follow up on application status and release claims when complete
Update carrier portals and CAQH with updated licensures
Maintain CAQH attestation for all providers
Collaborate with other teams in the department as needed

Requirements

Strong understanding of healthcare regulations and accrediting institutions
Excellent organizational and communication skills
Ability to work independently and manage multiple priorities
Proficiency in computer software and systems, including credentialing databases and insurance carrier portals

What We Offer

Ovation Healthcare offers a dynamic and supportive work environment, with opportunities for professional growth and development. We're committed to helping our employees succeed and thrive in their careers.