Credentialing Specialist

TeleSpecialists LLC•Brookhaven, GA

20d•Onsite

About The Position

TeleSpecialists is looking for a Credentialing Specialist III responsible for supporting the credentialing process of our providers by completing and/or processing credentialing applications and proactively monitoring the status of applications and outstanding items to ensure timely completion of credentialing for our providers. This is a senior level position on the credentialing team that plays a key role in our ability to efficiently privilege providers and scale our patient services. Essential Duties and Responsibilities Credentialing Specialist may perform some of the same responsibilities and tasks as the Credentialing Specialist I and II including: 1. Develop and maintain relationships within the credentialing and licensing teams, other internal departments and/or with our hospital partners 2. Performs data entry of physician’s information into various credentialing applications or systems for processing for both initial credentialing and reappointments 3. Reviews and analyzes provider’s information for accuracy and completeness. 4. Conducts regular follow-up on the status of applications, compiling all required outstanding documentation and verifying all data or documents have been received to process applications timely. 5. Documents within the credentialing and licensing software platform. 6. Makes leadership aware of any potential issues identified during the credentialing process and works in collaboration with provider to document/resolve the issue. 7. Delegated credentialing functions 8. Primary source verifications 9. Preparing credentialing files for review and approval Will assist with training and mentoring of Credentialing Specialist I’s and II’s. Identifying opportunities for improvement, leading special projects and implementing process improvement initiatives Responsible for assisting with oversight and performance of the team including quality assurance reviews, compliance with policies and procedures and regulatory requirements Other duties as assigned.

Requirements

3-5 years credentialing experience required
Experience working in a hospital, physician practice or healthcare setting is required
Ability to interact with internal and external customers
Experience in an administrative or operational support role
Ability to type 30+ WPM
Strong computer skills, being open and able to learn and use new technologies
Intermediate level skills with Microsoft Outlook, Excel and Word
Ability to effectively prioritise and execute tasks in a high-pressure environment
Ability to work independently and proactively in a fast-paced, dynamic environment

Nice To Haves

Bachelor’s Degree or equivalent is preferred
Certifications such as CPCS or CPCM is preferred

Responsibilities

Develop and maintain relationships within the credentialing and licensing teams, other internal departments and/or with our hospital partners
Performs data entry of physician’s information into various credentialing applications or systems for processing for both initial credentialing and reappointments
Reviews and analyzes provider’s information for accuracy and completeness.
Conducts regular follow-up on the status of applications, compiling all required outstanding documentation and verifying all data or documents have been received to process applications timely.
Documents within the credentialing and licensing software platform.
Makes leadership aware of any potential issues identified during the credentialing process and works in collaboration with provider to document/resolve the issue.
Delegated credentialing functions
Primary source verifications
Preparing credentialing files for review and approval
Assist with training and mentoring of Credentialing Specialist I’s and II’s.
Identifying opportunities for improvement, leading special projects and implementing process improvement initiatives
Responsible for assisting with oversight and performance of the team including quality assurance reviews, compliance with policies and procedures and regulatory requirements
Other duties as assigned.