Physician Services Analyst II

Inspire Health Medical Group•Fresno, CA

12d•Onsite

About The Position

JOB PURPOSE: A non-exempt position responsible for the accurate and timely processing of provider credentialing, enrollment, and re-credentialing for medical facilities and health plans. This role supports provider onboarding and ongoing compliance by coordinating with internal departments, practitioners, medical staff offices, and external payer entities to ensure credentialing requirements are met efficiently and in accordance with organizational policies.

Requirements

High School Diploma or equivalent; Associate’s degree preferred
Minimum two (2) years of credentialing experience in a medical setting
Proficiency in Microsoft Office programs (Excel, Word and Outlook) and Adobe Acrobat Professional
Strong attention to detail with the ability to manage multiple priorities and deadlines
Knowledge of business communication, including grammar, spelling, and professional correspondence
Ability to work independently and make decisions in a multi-faceted, fast-paced environment
Ability to handle sensitive and confidential information in a professional manner.
Verbal and written communication skills necessary to convey information effectively and professionally, with courtesy and tact.
Exceptional customer service skills necessary to communicate and follow instructions effectively from a diverse group of physicians and staff.
Ability to establish and maintain effective working relationships with other employees and the public.
Ability to identify problems, recommends solutions, organize and analyze information.

Responsibilities

Initiate and support the credentialing application process by requesting, receiving and analyzing the provider’s documents for submission to the facilities for approval for medical staff privileges and payer credentialing/enrollment
Collectively works with recruitment for onboarding practitioners and medical staff office team to assure practitioner’s credentialing process is efficient and timely
Use critical thinking to conduct follow-up with individual practitioners, internal and external entities to resolve discrepancies identified during credentialing and enrollment process that may inhibit timely onboarding
Manage all phases of payer credentialing/enrollment, re-credentialing/re-enrollment, notification of changes including termination of group practitioners
Complete regular follow-up with the payers to ensure credentialing and enrollment is complete and escalate communication with payer provider enrollment staff of any issues prohibiting timely credentialing/enrollment
Keep Physician Services Manager and supporting departments informed of potential credentialing and enrollment issues
Update and maintain provider credentialing information database and electronic data files in accordance with internal policies and procedures while also maintaining confidentiality of provider information
Actively participate in team meetings and process improvement initiatives to continuously improve work product and efficiency
Develop, document, and maintain accurate work instructions for the desk, ensuring all procedures and information remain current
Promote the purpose, values and foundations of Inspire Health Medical Group at all levels of the organization and to our customers
Perform other related duties as assigned to support Physician Services operations