Healthcare Credentialing Specialist: Enable Physician Networks

UHS; King of Prussia (PA); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Competitive Compensation

Generous PTO

Medical, Dental, Vision

401K with company match

Career development

Pet Insurance

Job summary

Independence Physician Management (IPM), a unit of Universal Health Services, seeks a Credentialing Specialist to manage physician credentialing for government and commercial payors. You will maintain data in Intellisoft, track time, and support other IPM locations.

Responsibilities include initial and re-credentialing, data entry, and reporting, ensuring timely enrollment and active status for contracted physicians across multiple markets.

Qualifications

• 3-5 years of experience with physician credentialing in a managed care environment.
• Comprehensive knowledge of the managed care industry and credentialing processes.
• Ability to communicate effectively with internal and external stakeholders.
• Experience with credentialing databases and data entry rules.
• Responsible for initial credentialing, re-credentialing, and modifications.

Responsibilities

• Submits and follows 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.

Skills

Credentialing experience

Communication skills

Managed care knowledge

Contracting knowledge

Education

High School Diploma/GED

Bachelor's degree preferred

Tools

Intellisoft

Job description

Independence Physician Management (IPM), a unit of Universal Health Services, seeks a Credentialing Specialist to manage physician credentialing for government and commercial payors. You will maintain data in Intellisoft, track time, and support other IPM locations.

Responsibilities include initial and re-credentialing, data entry, and reporting, ensuring timely enrollment and active status for contracted physicians across multiple markets.