Provider Credentialing Specialist

Summit Spine & Joint Centers; Lawrenceville (GA); On-site; USD 42,000 - 62,000; Full time

Job summary

Summit Spine & Joint Centers in Lawrenceville, GA, seeks a Credentialing Specialist to coordinate credentialing for medical staff and allied health professionals.

The role ensures timely contracting and credentialing, maintains CAQH profiles, and communicates with physicians on licensure, renewals, and network status; reporting to the Chief Administrative Officer.

Qualifications

• Minimum 1-year prior credentialing experience preferred
• CPCS certification (NAMSS) preferred
• Experience using eClinicalWorks preferred
• Bachelor's Degree preferred or equivalent experience

Responsibilities

• Coordinate credentialing for medical staff and allied health professionals.
• Monitor credentials and licenses to ensure compliance.
• Follow up with insurance carriers and provider networks on credentialing/ contracting status.
• Communicate licensure and renewal expirations with physicians and staff.
• Maintain CAQH profiles for physicians per Medicare regulations.
• Maintain records of licenses, credentials, and contracts.

Job description

Company Overview

Summit Spine and Joint Centers (SSJC) is on track to become the largest comprehensive spine and joint care provider in the state of Georgia and other surrounding areas while providing clinical, surgical, and imaging services to our patients. We are seeking qualified individuals to join our team and provide exceptional patient care!

Job Description Summary

The Credentialing Specialist shall be responsible for coordinating the credentialing of Medical Staff and Allied Health professionals. They shall ensure that contracting and credentialing is completed in a timely manner for all physicians.

This job is a full-time, benefited position at Summit Spine & Joint Centers that reports to the Chief Administrative Officer. Your assigned location is the Company’s administrative office in Lawrenceville, GA.

Responsibilities

• Ensure company and providers maintain compliance with all regulatory and accrediting institutions
• Monitor staff and provider credentials and licenses
• Follow-up with insurance carriers and provider networks regarding credentialing/contracting status for providers
• Communicate with physicians on licensure and document renewal expirations
• Complete contracting recredentialing application
• Maintain CAQH profiles for physicians based on Medicare regulations
• Keep records on licenses, credentials, and insurance contractsRelease information to agencies and members of the public as required by law
• Comfortable working in a growing, dynamic organization and able to navigate change
• Maintain a safe clean work environment
• Additional duties as assigned.
• The employee must communicate professionally, respectfully, and effectively with patients, visitors, clinicians, coworkers, and vendors, including in busy, demanding, or stressful circumstances.
• The employee must maintain professional composure and consistently perform assigned duties throughout the scheduled work period; manage routine workplace stressors and feedback without disrupting patient care, patient-facing operations, or coworkers’ work; and use established de-escalation and escalation procedures when appropriate.
• The employee must exercise sound judgment; maintain appropriate workplace boundaries; receive and respond to routine feedback and direction; protect confidential patient and business information; and address patient or workplace concerns through established supervisory and safety procedures. These functions are essential to the position.

Skills And Abilities

• Self-motivated with ability to thrive in a fast-paced, team environment
• Ability to multi-task, prioritize and manage time effectively
• Excellent written & verbal communication skills
• Personable and confident while providing exceptional patient care.

Education And Experience

• Minimum 1-year previous experience in credentialing preferred
• Certified Provider Credentialing Specialist (CPCS) through the National Association Medical Staff Services (NAMSS) preferred
• Experience using eClinicalWorks preferred
• Bachelor's Degree preferred, or equivalent combination of education, training, and experience