Credentialing Specialist
Full time, flexible hours
Reports to: Director, Medical Staff Services
About the Opportunity
Aligned Providers, an innovative and rapidly growing emergency medicine and hospital contract management services group, is seeking a detail-oriented Credentialing Specialist. This role will check that qualified physicians and advanced practice providers are authorized to perform their duties. As a Credentialing Specialist, you will be the gatekeeper verifying that provider credentials meet the standards set by regulatory bodies and institutions.
This role ensures that all group providers have proper certification, license and required items needed to practice medicine at specific facility sites. You will be responsible for conducting primary source verifications prior to submitting documents to medical staff offices or site administrators.
This role will work closely with Aligned Providers’ recruiter, site directors, site practice administrators, and group providers.
This is a full-time position with flexible hours, reporting to the Director of Medical Staff Services, or designee. Salary is in the range of $60-65k per year.
Essential Functions
In this position, you will help us succeed by effectively performing the following duties:
- Process and review initial credentialing and re-credentialing applications, along with supporting documentation
- Screen provider applications and supporting documentation to ascertain their eligibility
- Collect information from the National Practitioner Data Bank (NPDB), the applicant, and other relevant sources
- Identify discrepancies in information and conduct follow-ups/keep providers timely in submitting items based on start date
- Capture primary source documentation
- Preserve the confidentiality and safety of provider information
- Proactively monitor credential expiration dates and advise providers on renewal procedures
- Maintain accurate information for all providers, updating their personal information as necessary
- Assist as needed with the preparation and dissemination of timely and accurate prequalifying provider data
- Maintain meticulous databases of healthcare providers and their credentials, ensuring accuracy and completeness
- Research and stay abreast on the latest licensing and accreditation requirements
- Other duties as assigned*
*Please note: This job description is intended to provide a representation of responsibilities required. Teammates may be requested to perform job-related tasks other than those specifically presented in this job description.
Expectations of Teammate
“Our core values are all aligned around a culture of service to our hospital partners and our staff.”
- Trust – Always do the right thing.
- Growth – Continuously build on past success.
- Partnership – Every relationship is essential to our success.
- Quality – Constantly enhance experiences by replicating successful practices & innovations.
Competencies
In order to thrive as a Credentialing Specialist at Aligned Providers, the following set of prerequisite skills are required:
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- Effective and clear verbal and written communication skills
- Excellent interpersonal skills
- Demonstrated ability to lead and develop with a growing organization
- Demonstrated ability to serve as a successful participant with the team.
- Proven ability to practice a high level of confidentiality
- Deft organizational skills
- Ability to manage multiple priorities and meet deadlines
Work Environment
This is a normal office position requiring you to be onsite and utilizing computers and other office equipment. This is considered “light work,” which means that you may exert up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.
Given the nature of deadlines and urgent credentialing needs, you may work under stressful circumstances at times.
Experience
This is an entry-level to early-career position. Either a one year certificate from a college or technical school, or a minimum of 2 years of related experience is required. (2-3 years of relevant work experience is preferred.) Experience with client service, communication, problem solving, planning & organization, customer service, and computer skills are ideal.
If you are looking to put your credentialing skills to work in a rewarding environment that is an integral part of delivering quality patient care, this is the position for you. Help to ensure that our providers meet the standards for delivering safe care.