Credentialing and Licensing Manager

Professional Facility Services; Landover (MD); On-site; USD 60,000 - 90,000; Full time

Job summary

Professional Facility Services LLC in the United States is seeking a credentialing specialist to verify, track, and maintain licensure and certification for medical record reviewers and consulting providers.

You will monitor renewal dates, proactively manage re-credentialing to prevent lapses, and ensure licenses stay current throughout the contract term while maintaining professional standards in interactions with claimants.

Qualifications

• Bachelor's degree in healthcare administration or related field.
• 3+ years of experience in medical staff credentialing or provider enrollment.
• Familiarity with DC medical licensure requirements and provider credentialing databases.

Responsibilities

• Verify and maintain documentation of DC Board of Medicine certification/eligibility and licensure for all medical record reviewers prior to assignment.
• Track license renewal dates for all providers and proactively manage re-credentialing to prevent lapses.
• Maintain responsibility for ensuring examining providers keep required licenses current throughout the contract term.
• Monitor and reinforce standards requiring that providers treat claimants with courtesy, dignity, and respect.
• Maintain the credentialing file system for audit and District review.

Education

Bachelor's degree in healthcare administration or related field

Job description

Position Summary

Verifies, tracks, and maintains current licensure and certification for all medical record reviewers and consultative examination providers, and monitors provider conduct standards.

Key Responsibilities

• Verify and maintain documentation of DC Board of Medicine certification/eligibility and licensure for all medical record reviewers prior to assignment.
• Track license renewal dates for all providers and proactively manage re-credentialing to prevent lapses.
• Maintain responsibility for ensuring examining providers keep required licenses current throughout the contract term.
• Monitor and reinforce standards requiring that providers treat claimants with courtesy, dignity, and respect.
• Maintain the credentialing file system for audit and District review.

Minimum Qualifications

• Bachelor's degree in healthcare administration or related field.
• 3+ years of experience in medical staff credentialing or provider enrollment.
• Familiarity with DC medical licensure requirements and provider credentialing databases.