Medical Credentialing Specialist

9 hours ago


Brownsville, Texas, United States Spherion Full time

Credentialing Specialist Job Description

The Credentialing Specialist is a vital role within our organization, responsible for ensuring the credentialing and re-credentialing process for healthcare providers is managed efficiently and effectively. This position requires strong organizational and time management skills, as well as attention to detail and accuracy.

Key Responsibilities:

  • Credentialing Management: Oversee the initial credentialing and re-credentialing process for all healthcare providers, including physicians, nurses, and other medical staff.
  • Documentation: Collect, review, and verify all necessary documentation, including licenses, certifications, education, work history, and malpractice coverage.
  • Compliance: Ensure compliance with all applicable federal, state, and local regulations, as well as organizational policies and standards.
  • Database Maintenance: Maintain and update credentialing databases and systems to ensure accurate and current information.
  • Communication: Liaise with healthcare providers, insurance companies, and regulatory bodies to facilitate the credentialing process.
  • Problem Resolution: Address and resolve any issues or discrepancies related to provider credentials.
  • Reporting: Prepare and present reports on credentialing activities and status to management and relevant committees.
  • Audits: Assist with internal and external audits of credentialing processes and records.

Requirements:

  • High School degree or GED
  • Past experience in Credentialing for providers in a medical setting
  • Must be able to type 30 to 40 WPM
  • 1 to 2 years experience in a medical setting
  • Strong communication skills
  • Attention to detail
  • Medical terminology
  • Must live in South Texas from Brownsville, Texas to McAllen, Texas

About Spherion:

Spherion is an equal opportunity employer and welcomes people of all abilities. We offer a comprehensive benefits package and an incentive and recognition program. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.



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