Credentialing Specialist

DIVERSE LYNX LLC; New York (NY); On-site; USD 50,000 - 70,000; Full time

Job summary

A healthcare consulting firm in New York is seeking a Credentialing Specialist. The role involves managing provider credentialing, ensuring timely license renewals, and performing primary source verification. Candidates should be familiar with MDStaff software and regulations in credentialing. This is an on-site position, emphasizing data accuracy and compliance with standards.

Qualifications

• Experience with MDStaff credentialing software.
• Knowledge of accreditation and regulatory agency requirements.
• Ability to maintain accuracy and data integrity.

Responsibilities

• Facilitate all aspects of provider credentialing and re-credentialing.
• Ensure physician licenses are renewed prior to expiration.
• Complete primary source verification for new and existing providers.

Job description

Duties: The Credentialing Specialist is responsible for facilitating all aspects of provider credentialing, including initial appointment, reappointment, credential audits, as well as clinical privileging for Medical Staff, Allied Health Professionals, and all other providers as outlined in the corporate policy and procedures, or hospital bylaws. Utilize MDStaff credentialing software application to perform and monitor all credentialing/background checks, while maintaining accuracy and data integrity. Responsible for interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statutes and laws relating to credentialing. This is not a remote job and all work is performed on site.

Credentialing: Responsible for all aspects of provider credentialing and re-credentialing.

• License Renewals: Ensures that physician licenses are renewed prior to expiration.
• Primary Source Verification: Completes primary source verification for new and existing providers to ensure due diligence.
• Records Management: Maintains assigned physician files, updating each item/action as processed.
• Utilizes database status/alert and other report functions, software tools and links to scanned documentation.
• Ensures that information is current and accurate.
• Credentialing Standards: maintains consistency in database entry to ensure accurate and consistent processes.
• Back-up Coverage: provide credentialing back-up for other members of the credentialing group.