Credentialing & Licensing Specialist III
About The Position
The Credentialing & Licensing Specialist is responsible for linking and/or updating physician and mid-level providers with contracted insurance carriers. S/he also assists in staff privileges at area hospitals and nursing homes. S/he maintains current accurate information for the physicians and mid-level providers in MPG's database, with insurance carriers, and facilities. S/he will assist the Business Services teams as necessary. Responsible for new and existing applications and reappointment paperwork is complete, accurate and timely including tasks required for exiting providers. Collects and processes verification and accreditation information for all physicians and mid-level providers associated with insurance carriers. Tracks and renews physician and mid-level provider licensure as approved. Maintains professional and open communication with physicians, mid-level providers and individuals within MPG to ensure up to date and consistent record keeping. Ensures all provider files are current with Human Resources. Demonstrates proficiency in Microsoft Word, Excel, and software unique to credential (i.e. Intellisoft) or hospital on-line application processes. Use PRactice Management System, Credentialing software and relevant portals as needed to fulfill job responsibilities and/or other associated assignments. Keeps supervisor fully informed regarding job responsibilities and challenges to success. Demonstrate excellent interpersonal and communication skills.
Responsibilities
- linking and/or updating physician and mid-level providers with contracted insurance carriers
- assisting in staff privileges at area hospitals and nursing homes
- maintaining current accurate information for the physicians and mid-level providers in MPG's database, with insurance carriers, and facilities
- assisting the Business Services teams as necessary
- Responsible for new and existing applications and reappointment paperwork is complete, accurate and timely including tasks required for exiting providers
- Collecting and processing verification and accreditation information for all physicians and mid-level providers associated with insurance carriers
- Tracking and renewing physician and mid-level provider licensure as approved
- Maintaining professional and open communication with physicians, mid-level providers and individuals within MPG to ensure up to date and consistent record keeping
- Ensuring all provider files are current with Human Resources
- Demonstrating proficiency in Microsoft Word, Excel, and software unique to credential (i.e. Intellisoft) or hospital on-line application processes
- Using PRactice Management System, Credentialing software and relevant portals as needed to fulfill job responsibilities and/or other associated assignments
- Keeping supervisor fully informed regarding job responsibilities and challenges to success
- Demonstrating excellent interpersonal and communication skills
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
