All Star Recruiting is looking for a Credentialing Specialist to maintaining the credentialing and re-credentialing process for All Star Recruiting healthcare providers. The Credentialing Specialist will contact the medical office staff and insurance providers, as well as communicating with healthcare personnel to maintain up-to-date files on physicians and NP/PA. The Credentialing Specialist is also responsible for answering inquiries regarding providers' credential status and working with the locum’s division to ensure the accuracy of all files by tracking the expiration of licenses and certifications.
Essential Duties and Responsibilities:
- Compiles and maintains current and accurate data for all providers.
- Conduct thorough research and primary source verification of all components of the application file.
- Identify issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up under supervision from Supervisor, Internal Credentialing.
- Processes and completes provider credentialing and re-credentialing applications
- Sets up and maintains provider information in the Pulse and Share Drive.
- Process applications for appointment and reappointment of privileges.
- Tracks licenses, DEA certificates and professional liability expirations and any other required credentialing document for appointed providers.
- Handles telephone calls and assists callers by conveying their issues to the appropriate individual or department and performing follow-up, as required.
- Communicates credentialing requirements and documents as needed.
- Maintains knowledge of jurisdictional requirements and document credentialing changes as needed.
- Assists with internal file audits.
- Participates in the development of and adherence to: department rules and regulations; and policies pertaining to medical staff, practitioner/provider, and the organization.
- Utilizes credentialing databases, optimizing efficiency, and performs query, reports, and document generation; submits and retrieves National Practitioner Data Bank reports in accordance with Health
- Care Quality Improvement Act.
- Seek guidance from Internal Credentialing Specialist II when needed.
- Other duties as assigned and modified at manager’s discretion
Knowledge, Skills & Abilities:
- Excellent organizational and follow- up skills.
- Strong attention to detail.
- Ability to communicate effectively, both orally and in writing.
- Informational research skills.
- Database management skills including querying, reporting, and document generation.
- Knowledge and understanding of the credentialing process.
- Ability to organize and prioritize work and manage multiple priorities.
- Ability to work with general supervision.
- Knowledge of related accreditation and certification requirements.
- Knowledge of medical credentialing and privileging procedures and standards.
- Ability to analyze, interpret and draw inferences from research findings, and prepare reports.
- Working knowledge of clinical and/or hospital operations and procedures.
- Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
- Displays knowledge of key functions, terminology, and work products of legal, information technology, risk management and performance concepts
- High school diploma or equivalent required (Bachelor’s Degree Preferred)
- Minimum one (1) year experience in provider credentialing or in healthcare industry.
- Knowledge in managed care/insurance credentialing preferred
- Proficient use of Microsoft Office applications (Word, Excel, Outlook) and internet resources.
You've found the best when it comes to placing healthcare professionals for permanent or temporary (locum tenens) positions all across the country! Headquartered in Deerfield Beach, Florida, All Star Recruiting has been providing professional placement services and proven results to hospitals, physician groups, and practice management organizations since 2003. We pride ourselves being a recruitment firm that can provide swift, professional, and reliable service without the cost, multiple contacts, and headaches of a larger company. All Star Recruiting (ASR) is also looking for those talented, motivated, dedicated, energetic, hardworking individuals to join our very successful and growing team in the Broward/Palm Beach area.
Our culture is professional and fast-paced, yet not overly "corporate." We pride ourselves on effectively servicing our Providers, Clients, and the Community; while also focusing on our employees' personal, professional, and financial goals. As a Sun-Sentinel back-to-back "Top Places to Work" recipient, ASR is the company to join if you are looking for specialized development, benefits, competitive pay, and job expansion, in a fun and collaborative environment!
Role: Credentialing Specialist
Location: Deerfield Beach,
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