Medical Credentialing Specialist
6 days ago
JVM Solutions is hiring a Medical Credentialing Specialist to support a Processing Center in El Paso, TX.
Duties and Responsibilities
- Coordinate and communicate activities with the Credentialing Office supervisor or designee.
- Manage the credentialing process for healthcare providers and other licensed professionals through the process and units.
- Audit files for completed information upon submission and communicate with providers to address any discrepancies or missing information.
- Monitor expiring licenses and credentials, proactively initiating the renewal process to avoid any disruption in services.
- Verify the accuracy and completeness of healthcare provider applications, ensuring that all required documents are submitted.
- Maintain liaison and coordinate with internal and external agencies to obtain and update relevant provider information.
- Perform primary and secondary source verifications of credentials according to departmental policy.
- Establish and update practitioner's credentials files (PCF) and provider activity files (PAF) on providers going through the screening process.
- Notify Network Services Representatives and Credentialing Office supervisor within 72 hours of being unable to obtain required documentation or non-responsiveness.
- Prepare files for presentation to the Chief Medical Officer and Credentialing Committee.
Qualifications
- High school equivalent and have a minimum of one year of college education.
- Certification/registration as determined by the American Society for Clinical Pathology (ASCP) or AMT.
- Minimum 1 year of experience as a full-time Medical Credentialing Specialist within the last 3 years and at least 50% of the time was spent focused on verifying and maintaining the credentials of licensed, registered, and/or certified medical personnel, including but not limited to physicians, advanced practice registered nurses, physician assistants, therapists, etc.
- Basic Life Support (BLS) Certification from the American Red Cross or American Heart Association, maintained in current status.
Other Requirements
- Must pass a criminal background check.
- Must be a U.S. Citizen.
Johnson Venture Management Solutions, Inc. is an equal opportunity and affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
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