Credentialing Specialist

Job Posting Closing Date: Open until Filled

Where do you belong?

Your career is more than just a job, it's part of your life. Whether you’re a clinician, or non-clinical professional,  at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

USACS also understands that location is important. We offer  career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture,  outstanding benefits and competitive compensation package is best in class.

Job Description

The Credentialing Specialist evaluates, analyzes, and coordinates all credentialing and re-credentialing processes for Physicians and Advanced Practice Providers. The specialist provides integral support to our clinicians and hospital partners directly related to the hospital credentialing process.

Location: Remote

ESSENTIAL JOB FUNCTIONS:

• Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal & state regulations, guidelines, policies, and standards.
• Collects and validates clinicians’ documents to ensure the accuracy of all credentialing elements; assesses information and qualifications relative to credentialing standards
• Identifies, analyzes, and resolves extraordinary information, discrepancies, time gaps, and other idiosyncrasies that could adversely impact the ability to credential and enroll clinicians; discovers and conveys issues to clinical and credentialing leadership for sound decision-making following hospital bylaws, credentialing policies, and procedures, federal, state, local and government/insurance agency regulations
• Prepares, electronically tracks, and follows up on appropriate verifications for efficient, high-volume processing of individual applications following applicable credentialing standards, established procedural guidelines, and strict timelines.
• Monitors files to ensure completeness, accuracy, and timely submission; prepares and provides updates internally and externally.
• Enters, updates, and maintains data from clinicians’ applications into the credentialing database, focusing on accuracy, interpreting or adapting data to conform to defined data field uses, and following internal policies and procedures.
• Communicates concisely and timely with clinicians, hospital partners, and administration to provide updates on day-to-day credentialing and privileging.
• Identify, research, and resolve to license and credentialing issues.  Responsible for promptly communicating any potential start date delays to providers, department leadership, and the Medical Director.
• Partner with Provider Enrollment, Risk Management, Legal, and Scheduling to validate and supplement application content and to ensure clinicians are privileged according to their contracted start date.

KNOWLEDGE, SKILLS AND ABILITIES:

• Strong analytical and problem-solving skills
• Strong communication and interpersonal skills
• Ability to organize and prioritize job tasks and requirements
• Ability to effectively perform tasks in a fast-paced work environment
• Excellent organizational skills with the ability to prioritize assigned duties in an efficient amount of time.
• Ability to effectively use oral and written communication skills with clinicians, external agencies, and management courteously and professionally. Must have a strong knowledge of correct English, proper grammar, and spelling.
• Demonstrated advanced working knowledge of spreadsheets and database management with a strong emphasis on Microsoft Office Programs- Outlook, Word, Excel, DocuSign, Zoom, Dropbox, and Adobe Acrobat.

EDUCATION AND EXPERIENCE: 

• High school diploma or GED required; Completed degree(s) from an accredited institution above the minimum education requirement may be substituted for experience on a year-for-year basis.
• Minimum 4 years’ experience related to the duties and responsibilities specified.

PHYSICAL DIMENSIONS:

• While performing the duties of this job, the employee is regularly required to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds. 

• Required to have close visual acuity to perform the job.                   

Hourly Rate: $18.76 - $34.70