Credentialing Specialist

AtWork Group; Corpus Christi (TX); On-site; USD 45,000 - 65,000; Full time

Job summary

AtWork Group is seeking a Provider Credentialing Specialist in Corpus Christi, Texas. This role involves verifying the credentials and qualifications of medical providers to ensure they meet necessary standards. Responsibilities include conducting thorough verifications, maintaining an accurate credentialing database, and staying informed about regulatory changes.

The ideal candidate has experience in healthcare credentialing and strong organizational skills. This position plays a crucial role in ensuring quality care delivery.

Qualifications

• Experience in verifying medical provider education and licensure.
• Knowledge of healthcare regulations and compliance standards.
• Strong organizational and documentation skills.

Responsibilities

• Conduct comprehensive verification of medical provider credentials.
• Maintain an accurate credentialing database and track expirations.
• Prepare documentation for audits and accreditation processes.

Job description

Job Summary: The Provider Credentialing Specialist is responsible for verifying the credentials and qualifications of medical providers, ensuring they meet the necessary standards to deliver quality care. This role involves interacting with various organizations, including medical schools, licensing boards, and insurance companies, to confirm the credentials of physicians and advanced practice providers.

Responsibilities

• Conduct comprehensive verification of medical provider education, training, licensure, and board certifications.
• Review, organize, and maintain all credentialing documentation, ensuring it is complete and complies with federal, state, and insurance regulations.
• Liaise with medical schools, residency programs, and licensing boards to obtain verification of credentials and ensure all necessary documentation is current.
• Assist in the onboarding process for new providers by preparing credentialing applications for hospitals and insurance payers, ensuring all submissions meet compliance standards.
• Maintain an accurate and up-to-date credentialing database, tracking license expirations, board certifications, and continuing education requirements.
• Stay informed about changes in healthcare regulations and standards relevant to provider credentialing.
• Prepare documentation and reports for internal audits, accreditation processes, and external reviews as needed.
• Serve as a point of contact for providers regarding credentialing requirements, processes, and status updates.

Quality Assurance

Implement best practices in credentialing processes to enhance efficiency and accuracy.