Credential Specialist

Downer Grove, IL
Posted 7 months ago

A physician group seeking an experienced full-time Credentialing Specialist with at least 3+ years of recent and related work experience. You will be responsible for coordinating the credentialing process, which includes gathering all credentialing materials, maintaining and updating records and documentation, reaching out for follow-up and problem resolution and ensuring ongoing compliance as required by the regulatory agencies.

ESSENTIAL JOB FUNCTIONS:

  • Complete and monitor initial hospital applications and reappointments.
  • Database management including maintaining current and accurate data for all providers.
  • Report and document generation.
  • Assist with payor enrollment.
  • Maintains confidentiality of provider information.
  • Is responsible for daily provider data management and review of credentialing files; ensuring files are complete and accurate.
  • Monitors & conducts follow-up regarding supportive credentialing documentation including
    licensure, malpractice status and history, board certification, medical staff dues, etc.
  • Responds to inquiries in a timely manner by a variety of means; letter, telephone, or email.
  • Informs manager of any concerns in a timely manner.
  • Facilitate state licensure applications as needed.
  • Self-motivator who is thorough, detail-oriented, with strong organization skills.
  • The ability to prioritize work and manage multiple priorities.
  • Strong analytical detail and organizational skills with a focus on deadlines.
  • Excellent written and verbal communication skills.
  • Ability to research and analyze data, work independently.
  • Must have positive, professional demeanor to establish and maintain effective working
    relationships with providers, management, staff, and contacts outside the organization.
  • Proficient computer skills and good typing.
  • Must be a team player and proactive.
  • Identify ongoing lean process improvement needs and assist with developing and implementing the required processes or protocols.

QUALIFICATIONS:

  • Certification as a Certified Provider Credentialing Specialist (CPCS) desired.
  • Bachelor degree required.
  • 3-5 years of experience in medical credentialing working for a private practice desired.

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