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Credentialing Specialist

Summit Medical Group, Llc
Summit Medical Group, LLC
2+ years
60,000 per year
10 July 31, 2024
Job Description
Job Type: Full Time Remote Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

About Us

Aligned Providers is a leading emergency medicine and hospital medicine contract management services company, helmed by experienced clinical executives. Our mission is to create meaningful alignment between hospitals, providers, staff, and patients through tailored consultative, administrative, clinical, and operational services.

Position Description

We are looking for a detail-oriented and organized Credentialing Specialist to join our dynamic team. This essential role involves ensuring our healthcare providers meet all necessary qualifications and compliance standards. The ideal candidate will possess a strong understanding of credentialing processes and regulatory requirements, with the ability to manage multiple tasks efficiently.

Responsibilities

  • Process and review initial credentialing and re-credentialing applications, including supporting documentation.
  • Screen provider applications and documents to verify eligibility.
  • Collect information from the National Practitioner Data Bank (NPDB), applicants, and other relevant sources.
  • Identify and address discrepancies in information, ensuring timely submission of required items based on start dates.
  • Capture and maintain primary source documentation.
  • Protect the confidentiality and safety of provider information.
  • Proactively monitor credential expiration dates and guide providers through renewal procedures.
  • Keep accurate records of all providers, updating personal information as needed.
  • Assist in preparing and distributing accurate prequalifying provider data.
  • Maintain meticulous databases of healthcare providers and their credentials.
  • Stay updated on the latest licensing and accreditation requirements.

Qualifications

  • One year certificate from a college or technical school, or a minimum of two to three years of related experience.

Preferred Qualifications

  • Knowledge of healthcare industry regulations and standards.
  • Experience with credentialing software.
  • Certification in healthcare credentialing.

We Offer

  • Competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • A supportive and collaborative work environment.

Additional Requirements

Background Investigation: We will verify the information you provide, including your employment history, education, and references. A criminal background check may also be conducted based on the position and local laws. Disclosure of any information revealed in the background check is required. Falsification or misrepresentation of information may impact your candidacy negatively.

Drug Screening: A drug screening test is required. A positive result for illegal substances, refusal to take the test, or tampering with the results may lead to the withdrawal of a job offer or termination of employment.

Apply Today! If you are a meticulous professional with a passion for ensuring compliance and maintaining high standards, we encourage you to apply and become a part of our dedicated team at Aligned Providers.

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