Credentialing & Licensing Specialist

1 week ago


Pittsburgh, Pennsylvania, United States RAYUS Radiology Full time $45,000 - $65,000 per year

RAYUS now offers DailyPay Work today, get paid today

RAYUS Radiology is looking for a Credentialing & Licensing Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together As a Credentialing & Licensing Specialist, you will be responsible for physician state licensing initiatives, facility privileging and internal appointments and reappointments, including conducting follow-up and timely responses to questions regarding pending applications. This role coordinates and completes licensing and/or facility privilege requests in a timely manner, maintains electronic files (for licensure and privileging) and ensures the credentialing database is kept current. This is a remote, full-time position, working 40 hours per week, Monday thru Friday; Corporate hours.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

(55%) Provider Licensure

  • Compiles documents for state medical licensing boards for providers.

  • Works closely with physicians throughout the licensing process.

  • Track documents and timeframes associated with licensing and CME organization and knowledge of state licensing requirements related to CMEs.

  • Process State License renewals, DEAs, BLS, ALS, CDS and other certifications for state licensure.

  • Coordinates with other departments as needed for licensure priority according to staffing needs

  • Research state medical board requirements for physician providers as needed.

  • Runs database reports, NPDBs, etc. as needed.

  • Must meet all deadlines regarding provider licensure

(45%) Provider Privileging

  • Receives, evaluates and processes initial and reappointment applications including performing all applicable credentialing and recredentialing verification functions

  • Reviews the medical staff application for completeness and accuracy to initiate the verification process

  • Maintains accurate credentials for each provider (e.g., license status and expirations, board certifications, reappointments, and malpractice coverage)

  • Generates and analyzes reports from specialty database to monitor credentials of each provider

  • Communicates with providers and assigned departments to gather current credentials, as needed

  • Coordinates and monitors medical staff licensure applications/status changes and maintains Verity credentialing database

  • Communicates with internal and external colleagues and resources

  • Assists in organizing and development of monthly Credentials Committee Agenda Performs

(5%) Other Duties and Projects as Assigned

Requirements:

Required:

  • High school diploma, or equivalent

  • Three (3) years' experience with physician/provider licensure, privileging and credentialing

  • Familiarity with federal/state and regulatory and/or accrediting agencies

  • Previous customer service experience

  • Proficiency using Microsoft Office Suite applications

  • Proficiency using various computer systems and proficient typing skills

Preferred:

  • Associate degree

  • Working knowledge of CMS, CAQH, IMLCC, NPDB, and JCAHO

  • Certified Provider Credentialing Specialist (CPCS) OR Certified Professional Medical Services Management (CPMSM)

RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible.

We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services RAYUS Radiology is an EO Employer/Vets/Disabled.

We offer benefits (based on eligibility) including medical, dental and vision insurance, 401k with company match, life and disability insurance, tuition reimbursement, adoption assistance, pet insurance, PTO and holiday pay and many more Visit our career page to see them all

DailyPay implementation is contingent upon initial set-up period.



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