Job Description

Job Description

The Credentialing Specialist is responsible for all aspects of the credentialing, recredentialing and privileging processes for all physicians and advanced practice providers. Responsible for ensuring providers are credentialed, appointed, and privileged with hospitals and patient care facilities in accordance with established accreditation, regulatory and policy requirements. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.

Essential Duties and Responsibilities:

• Compiles and maintains current and accurate data for all providers using the credentialing software.
• Completes hospital appointment and reappointment applications; monitors applications to ensure timely start dates and no lapses in privileges.
• Maintains copies of current state licenses, CDS/DEA certificates, health history, malpractice coverage and any other required credentialing documentation for all providers.
• Maintains knowledge of current accreditation, regulatory and policy requirements.
• Apply for state licensure, and any other licenses or certifications as needed to meet state and facility requirements.
• Monitors maintenance criteria and continuing medical education required to maintain hospital privileges and licensure.
• Other duties or projects as assigned.

Required Experience:

• A minimum of two years of relevant credentialing, licensing and/or enrollment experience.

Knowledge and Skills:

• Knowledge and understanding of the credentialing and enrollment process.
• Ability to organize and prioritize work and manage multiple priorities.
• Excellent verbal and written communication skills.
• Excellent attention to detail.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• Proficient use of Microsoft Office applications (Word, Excel, Access) and credentialing software.
• MD Staff software experience strongly preferred

Education/Licensing/Certification:

• Associates degree preferred or appropriate combination of education and experience.

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