Credentialing Specialist

About the role

Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit here.

Responsibilities

• Gathers, researches, compiles and documents physician data used in the credentialing process.
• Investigates discrepancies, reports and documents findings.
• Maintains databases/records of required provider information, including but not limited to licensures and documents.
• Performs new provider credentialing activities including preparation of new provider files to be presented to the Board or Credentialing Committee per NCQA Standards.
• Sends hospital privilege applications to the appropriate facilities in a timely manner and addresses additional requests relating to such as necessary.
• Maintains credentialing files and monitors/ tracks Medicare and Medicaid enrollment process.
• Maintains licensure/insurance expiration date activity for both internal and external providers.
• Maintains all required regulatory websites as required by NCQA Standards.
• Documents findings and reports any issues identified to Supervisor.

Requirements

• High school diploma or GED.
• One (1) or more years of clerical experience.
• Experience working in credentialing and/or medical office.
• Experience using credentialing software.

Qualifications

• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent verbal and written communication skills.
• Excellent attention to detail.
• Excellent customer service skills.
• Excellent interpersonal & problem solving skills.
• Ability to work in a team environment as well as independently.
• Ability to engage others, listen and adapt response to meet others’ needs.
• Ability to align own actions with those of other team members committed to common goals.
• Ability to organize and prioritize own work schedule.
• Ability to manage competing priorities.
• Ability to perform job duties in a professional manner at all times.
• Ability to understand, recall, and communicate, factual information.
• Ability to understand, recall, and apply oral and/or written instructions or other information.
• Ability to organize thoughts and ideas into understandable terminology.
• Ability to apply common sense in performing job.

Work Schedule

Monday - Friday 8AM - 5PM (Hybrid)

Skills

• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent verbal and written communication skills.
• Excellent attention to detail.
• Excellent customer service skills.
• Excellent interpersonal & problem solving skills.
• Ability to work in a team environment as well as independently.
• Ability to engage others, listen and adapt response to meet others’ needs.
• Ability to align own actions with those of other team members committed to common goals.
• Ability to organize and prioritize own work schedule.
• Ability to manage competing priorities.
• Ability to perform job duties in a professional manner at all times.
• Ability to understand, recall, and communicate, factual information.
• Ability to understand, recall, and apply oral and/or written instructions or other information.
• Ability to organize thoughts and ideas into understandable terminology.
• Ability to apply common sense in performing job.

Behaviors

• Professionalism.
• Teamwork.
• Communication.
• Problem-solving.
• Attention to detail.
• Customer service.

Motivations

• Commitment to excellence.
• Passion for healthcare.
• Desire to contribute to a growing organization.
• Interest in credentialing and medical office operations.

Licenses & Certifications

• N/A

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.