Credentialing Specialist

DIMENSIONS/SCOPE OF POSITION

Performs centralized physician credentialing and related activities. Completion and maintenance of physician and other provider files, including current licenses, Drug Enforcement Agency (DEA) certifications, hospital and other facility applications and privileges, insurance plan applications, and credentials updates. Access to extensive and sensitive financial reimbursement and physician personnel information.

Reasonable Accommodations StatementTo accomplish this job successfully, an individual must be able to satisfactorily perform each essential function, with or without reasonable accommodation. Reasonable accommodation may be made to help qualified individuals with disabilities perform the essential functions.

ESSENTIAL DUTIES/RESPONSIBILITIES

Completes initial/renew Provider license/DEAsCompletes Provider credentialing/re-credentialing applications for facilities and payers. Also, completes new fellow/new provider initial credentialing applications for payers (and facilities for new providers)Communicate with new fellows/ providers throughout the credentialing process to ensure timely completionMaintains updated records, expiration, renewal dates, etc., through credentialing softwareScan the file of credentialing records and applicationsRegular and predictable attendance.

Ability to work cooperatively with others.

Perform other duties as assigned.

SUPERVISORY RESPONSIBILITIES

N/AQUALIFICATIONS:

Education and/or

Experience:

An Associates or Bachelors degree in Healthcare Administration, Business, or Office Administration is often preferred. 1 year of experience required.

Language Skills:

Able to communicate effectively in the English language.

Mathematical Skills:

Basic arithmetic skills are required.

Reasoning Ability:

Identifies and resolves problems promptly.

Computer Skills:

Must be computer-literate. Basic computer skills required.

Certificates, Licenses:

Must obtain Certified Provider Credentialing Specialist certification (CPCS) within 1 year of employment.

Other Skills and Abilities:

Able to listen and respond well to questions and feedback. Must have knowledge of medical staffing rules and regulations, Provider onboarding, health plans, compliance, audits, and ambulatory surgery center requirements.

Other Qualifications:

Nothing listed on the current Job description.

Campbell Clinic Benefit Summary:

Campbell Clinic offers a lucrative benefit package to support employees and their families.

Medical / Dental / Vision InsuranceHRA OptionFlexible Spending Account Basic Life Insurance Voluntary Life Insurance OptionLong-Term DisabilityVoluntary Short-Term Disability Accident Insurance Critical Illness Insurance401(k) Plan Matching + Profit Sharing Employee Assistance Program Paid Time Off 8 Paid Holidays Equal Opportunity Employer/Veterans/Disabled