Credentialing Specialist

TeleSpecialists; Fort Myers (FL); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Tuition reimbursement

Paid vacation

Leadership training

Job summary

TeleSpecialists is seeking a Credentialing Specialist III to support the credentialing process for our providers, ensuring timely completion of applications and assisting with training of junior specialists. This senior role emphasizes accuracy, collaboration with hospital partners, and continuous process improvements.

You will play a key part in efficiently privileging providers and scaling patient services, working in a dynamic healthcare environment with limited travel.

Qualifications

• Bachelor’s Degree or equivalent preferred.
• 3-5 years credentialing experience required.
• Experience in hospital/physician practice or healthcare setting required.
• CPCS or CPCM certifications preferred.

Responsibilities

• Develop and maintain relationships within credentialing and licensing teams and hospital partners.
• Enter physician information into credentialing applications.
• Review provider information for accuracy and completeness.
• Follow up on application status and document outstanding items.
• Prepare credentialing files for review and approval.
• Mentor Credentialing Specialists I & II and lead process improvements.

Skills

Credentialing

Data entry

Communication

Prioritization

Independent work

Computer skills

Outlook/Excel/Word

Education

Bachelor’s degree or equivalent

Tools

Microsoft Outlook

Excel

Word

Job description

TeleSpecialists is transforming healthcare delivery as the nation's largest and fastest-growing digital healthcare leader. By providing expert neurological and psychiatric care directly to over 400 hospitals and health systems across the country, we don't just provide care; we pioneer solutions that make quality healthcare easily accessible.

Join a team where your passion meets our purpose. If you’re inspired by innovation, thrive in a collaborative and entrepreneurial environment, and want to be a part of a team that’s reshaping the future of patient care, we want you on our team. At TeleSpecialists, you'll discover more than just a job. You will be able to experience meaningful work, accelerated career growth, and the opportunity to redefine healthcare for the future.

Tele Specialists Offers:

• A great culture with a team environment
• A fun, diverse work environment
• A rapidly growing company with career advancement opportunities
• Medical, Dental and Vision benefits
• Tuition Reimbursement
• Paid Vacation
• Leadership Training Classes

About the Role:

Tele Specialists is looking for a Credentialing Specialist III responsible for supporting the credentialing process of our providers by completing and/or processing credentialing applications and proactively monitoring the status of applications and outstanding items to ensure timely completion of credentialing for our providers. This is a senior level position on the credentialing team that plays a key role in our ability to efficiently privilege providers and scale our patient services.

Essential Duties and Responsibilities

• Credentialing Specialist may perform some of the same responsibilities and tasks as the Credentialing Specialist I and II including:
• Develop and maintain relationships within the credentialing and licensing teams, other internal departments and/or with our hospital partners
• Performs data entry of physician’s information into various credentialing applications or systems for processing for both initial credentialing and reappointments
• Reviews and analyzes provider’s information for accuracy and completeness.
• Conducts regular follow-up on the status of applications, compiling all required outstanding documentation and verifying all data or documents have been received to process applications timely.
• Documents within the credentialing and licensing software platform.
• Makes leadership aware of any potential issues identified during the credentialing process and works in collaboration with provider to document/resolve the issue.
• Delegated credentialing functions
• Primary source verifications
• Preparing credentialing files for review and approval
• Will assist with training and mentoring of Credentialing Specialist I’s and II’s.
• Identifying opportunities for improvement, leading special projects and implementing process improvement initiatives
• Responsible for assisting with oversight and performance of the team including quality assurance reviews, compliance with policies and procedures and regulatory requirements
• Other duties as assigned.

Qualifications

• Bachelor’s Degree or equivalent is preferred
• 3-5 years credentialing experience required
• Certifications such as CPCS or CPCM is preferred
• Experience working in a hospital, physician practice or healthcare setting is required

Knowledge, Skills, and Abilities

• Ability to interact with internal and external customers
• Experience in an administrative or operational support role
• Ability to type 30+ WPM
• Strong computer skills, being open and able to learn and use new technologies
• Intermediate level skills with Microsoft Outlook, Excel and Word
• Ability to effectively prioritise and execute tasks in a high-pressure environment
• Ability to work independently and proactively in a fast-paced, dynamic environment

Travel Requirements (if applicable):

minimal (less than 5%)

Other Duties:

This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Duties, responsibilities, and activities may change or be assigned at any time based on business needs.

Physical Requirements:

• Must be able to remain in a stationary position (sitting or standing) for prolonged periods, often up to 75% of the workday.
• Needs to occasionally move about inside the office to access file cabinets, office machinery, or shared workspaces.
• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and printer.
• Must be able to exchange accurate information with clients and co-workers in person, over the phone, and via digital platforms.
• Occasionally moves or transports office supplies, files, or equipment weighing up to 25 pounds.
• Occasionally positions self to maintain files in cabinets or access equipment stored in low or high areas.
• Requires close visual acuity to perform activities such as preparing and analyzing data, transcribing, and viewing a computer monitor for extended periods.

Equal Employment Opportunity & ADA Statement

The Company is an equal opportunity employer and is committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected by applicable law. The Company will provide reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws.