Credentialing Specialist

Horizon Health Corporation; King of Prussia (PA); Sur place; USD 52 000 - 68 000; Plein temps

Avantages offerts par ce poste

Medical, Dental, Vision plans

401(K) with company match

Paid Time Off

Pet Insurance

Résumé du poste

Universal Health Services (UHS) seeks a Credentialing Specialist within Independence Physician Management. The role ensures timely credentialing with government agencies and commercial payors, supporting multiple IPM locations and maintaining credentialing data.

The specialist will manage data entry in Intellisoft, report time weekly, and maintain contract files while collaborating with internal departments and payer contacts.

Qualifications

• High School Diploma/GED required; Bachelor's degree preferred
• 3–5 years of experience with physician credentialing in a managed care environment
• Comprehensive knowledge of the managed care industry with emphasis on credentialing
• Broad understanding of the managed care contracting process
• Ability to communicate effectively with internal departments, physicians, physician group management staff and managed care companies

Responsabilités

• Submits and follows up on credentialing to all contracted payors and government agencies timely and accurately
• Supports other IPM locations with credentialing as needed
• Maintains appropriate tracking of time and reports weekly as established by Credentialing Department
• Enters and maintains data in the credentialing database, Intellisoft
• Ensures demographic changes to contracted physicians are promptly reported to all contracted payers and government agencies
• Performs database queries and reports as needed
• Maintains managed care contract files and department databases for contracts and credentialing

Connaissances

Credentialing

Communication

Managed care knowledge

Formation

High School Diploma/GED

Bachelor's degree preferred

Outils

Intellisoft

Description du poste

Responsibilities

Independence Physician Management (IPM) was formed in 2012 as the physician services unit. IPM develops and manages multi-specialty physician networks and urgent care clinics within the Acute Care and Behavioral Health Divisions. A subsidiary of UHS, IPM operates in 13 markets across 7 states - and counting. We help doctors manage their practices and clinical procedures so they can concentrate on caring for their patients.

To learn more about IPM visit Physician Services - Independence Physician Management - UHS.

The IPM Credentialing Specialist ensures that the credentialing requirements for governmental agencies and commercial managed care insurers/networks are met and managed timely so that physicians are enrolled in and maintain active credentialing status with such entities. They are also responsible for credentialing, as assigned, to other IPM physician group models.

Job Duties & Responsibilities:

• Submits and follow up on credentialing to all contracted commercial payors and government agencies timely and accurately.


• Supports other IPM locations with credentialing as needed and maintains close working relations with appropriate contacts to keep them well informed.


• Maintains appropriate tracking of time and promptly reports it on a weekly basis as established by the Credentialing Department.


• Enters and maintains data in the credentialing database, Intellisoft, according to established data entry rules and policies.


• Ensures that demographic changes to contracted physicians are promptly reported to all contracted managed care companies and governments agencies.


• Performs database queries and reports as needed.


• Maintains managed care contract files (paper and electronic) and department databases for contracts and credentialing.

Benefit & Rewards Highlights

• Challenging and rewarding work environment


• Competitive Compensation & Generous Paid Time Off


• Excellent Medical, Dental, Vision and Prescription Drug Plans


• 401(K) with company match and discounted stock plan


• Career development opportunities within UHS and its 300+ Subsidiaries!


• Pet Insurance


• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World's Most Admired Companies™ and in 2025, was listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

Qualifications

• High School Diploma/GED required. Bachelor's degree preferred, but commensurate work experience in progressively responsible administrative positions will be considered.


• 3 - 5 years of experience with physician credentialing and/or physician contracting requirements in a managed care environment.


• Comprehensive knowledge of the managed care industry, with specific emphasis on physician credentialing and/or physician contracting requirements.


• A broad understanding of the managed care contracting process is required and knowledge of managed care payers' processes.


• Responsible for credentialing activities as it relates to initial credentialing, re-credentialing, and credentials modification.


• Ability to communicate effectively both verbally and in writing with internal departments, physicians, physician group management staff and managed care companies to achieve the necessary results required in the credentialing process and support of the Credentialing Department.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

• High School Diploma/GED required. Bachelor's degree preferred, but commensurate work experience in progressively responsible administrative positions will be considered.


• 3 - 5 years of experience with physician credentialing and/or physician contracting requirements in a managed care environment.


• Comprehensive knowledge of the managed care industry, with specific emphasis on physician credentialing and/or physician contracting requirements.


• A broad understanding of the managed care contracting process is required and knowledge of managed care payers' processes.


• Responsible for credentialing activities as it relates to initial credentialing, re-credentialing, and credentials modification.


• Ability to communicate effectively both verbally and in writing with internal departments, physicians, physician group management staff and managed care companies to achieve the necessary results required in the credentialing process and support of the Credentialing Department.

Qualifications

• High School Diploma/GED required. Bachelor's degree preferred, but commensurate work experience in progressively responsible administrative positions will be considered.


• 3 - 5 years of experience with physician credentialing and/or physician contracting requirements in a managed care environment.


• Comprehensive knowledge of the managed care industry, with specific emphasis on physician credentialing and/or physician contracting requirements.


• A broad understanding of the managed care contracting process is required and knowledge of managed care payers' processes.


• Responsible for credentialing activities as it relates to initial credentialing, re-credentialing, and credentials modification.


• Ability to communicate effectively both verbally and in writing with internal departments, physicians, physician group management staff and managed care companies to achieve the necessary results required in the credentialing process and support of the Credentialing Department.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Responsibilities

Independence Physician Management (IPM) was formed in 2012 as the physician services unit. IPM develops and manages multi-specialty physician networks and urgent care clinics within the Acute Care and Behavioral Health Divisions. A subsidiary of UHS, IPM operates in 13 markets across 7 states - and counting. We help doctors manage their practices and clinical procedures so they can concentrate on caring for their patients.

To learn more about IPM visit Physician Services - Independence Physician Management - UHS.

The IPM Credentialing Specialist ensures that the credentialing requirements for governmental agencies and commercial managed care insurers/networks are met and managed timely so that physicians are enrolled in and maintain active credentialing status with such entities. They are also responsible for credentialing, as assigned, to other IPM physician group models.

Job Duties & Responsibilities:

• Submits and follow up on credentialing to all contracted commercial payors and government agencies timely and accurately.


• Supports other IPM locations with credentialing as needed and maintains close working relations with appropriate contacts to keep them well informed.


• Maintains appropriate tracking of time and promptly reports it on a weekly basis as established by the Credentialing Department.


• Enters and maintains data in the credentialing database, Intellisoft, according to established data entry rules and policies.


• Ensures that demographic changes to contracted physicians are promptly reported to all contracted managed care companies and governments agencies.


• Performs database queries and reports as needed.


• Maintains managed care contract files (paper and electronic) and department databases for contracts and credentialing.

Benefit & Rewards Highlights

• Challenging and rewarding work environment


• Competitive Compensation & Generous Paid Time Off


• Excellent Medical, Dental, Vision and Prescription Drug Plans


• 401(K) with company match and discounted stock plan


• Career development opportunities within UHS and its 300+ Subsidiaries!


• Pet Insurance


• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World's Most Admired Companies™ and in 2025, was listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.