Physician Credentialing Specialist

Position Summary

The Physician Credentialing Specialist is responsible for credentialing new providers and maintaining current provider files for the growing multi-specialty physician group. They are responsible for submitting and tracking credentialing applications to various contracted insurances for oncoming providers. They will maintain the data for all providers within the group, track the expiration of certification and licenses, and act as a liaison between hospital administration and medical staff, including physicians.

Qualifications

• At least three (3) years of medical services experience is preferred.
• Knowledge of medical terminology, strong organization skills, good written communication skills, ability to work independently, and ability to conduct research while performing job duties is required.
• The position also requires a person who is able to communicate well with all levels of staff, physicians, and patient referral sources. He/she is flexible, responsible for assignments, and supportive of team efforts.

Duties and Responsibilities

• Ensures all necessary licenses and credentials are verified and updated for the facility.
• Conduct background checks.
• Contact licensing boards.
• Review license applications.
• Obtain education information.
• Complete references.
• Ensure the facility is operating within state and federal regulations.
• Create and continually cultivate business development and growth.
• Create and lead a culture centered on business development and customer service.
• Model customer service to patients, families, staff, physicians, and the referral community.
• Travel is primarily local during the business day, although some out-of-the area and overnight travel may be expected.
• Consistently behave in a professional and ethical manner, adhering to all policies related to ethics, HIPAA, and professional standards.

Salary Description

$21.00 - $24.00