- Monday-Friday
- No Weekends
- No On-Call
- Hybrid schedule- 1-2 days per week in office.
- Practically Free Vision & Dental
- Practically Free Medical Starting as Low as $20/Month
- Immediate Matching 401k contributions
- Furthering Education Assistance
- Salary: $52,000-$57,000 per year
- Maintain physician and facility records by organizing and updating files while keeping both parties up to date with the most recent documents.
- Provide physicians with materials required for licensing and guide them through the process
- Credentialing physicians with facilities and payers by communicating and exchanging necessary information.
- Prepares and monitors timeline reports for physician licensing and credentialing.
- Enhances physicians experience by being their documentation expert from start to finish.
- Updates job knowledge by participating in educational opportunities.
- Answers and delegate incoming calls and messages related to credentialing, licensing, and physician records
- Build and establish relationships with state licensing boards, credentialing agencies, and managed care organizations
- Continuously evaluate current processes looking for more efficient solutions
- Receives and processes all initial credentialing and recredentialing applications.
- Collects all pertinent information from the provider, provider's malpractice insurer, National Practitioner Data Bank (NPDB) and other sources as deemed appropriate.
- Ensures credentialing and recredentialing of providers occurs promptly following industry and company standards and criteria.
- Maintains accurate and complete records of each application's status.
- Enters all provider information into database.
- Prepares all documents to be reviewed by management and/or client credentialing partners.
- Attends Credentialing-related meetings when necessary.
- Maintains all credentialing and recredentialing timelines and schedules.
- Maintains strict confidentiality on all matters related to providers.
- Maintains well-organized provider files for easy review by management or client providers, outside review bodies, and others.
- Processes approval, denial, or termination communications with providers and/or clients.
- Performs other related duties as assigned by management.
- Stay current on practice management trends and matters.
- Education: HS Diploma or GED required. Bachelors Degree preferred.
- 1-2 years of related credentialing experience required
- Commitment to excellence and high standards
- Excellent written and oral communication skills
- Ability to manage priorities and workflow
- Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm
- Ability to work independently and as a member of various teams and committees
- Ability to understand and follow written and verbal instructions.
- Acute attention to detail
- Demonstrated ability to plan and organize projects
- Able to work collaboratively with multiple health professionals in a busy and complex environment using tact, diplomacy, and discipline.
- Ability to communicate professionally and effectively in person, on the phone, electronically, or through other means to individuals and groups.
- Excellent customer service skills.
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Credentialing Specialist - Nashville, United States - Psychiatric Medical Care
Description
Who We Are: Psychiatric Medical Care is a leading Behavioral Health Management company in the U.S. Why choose PMC? Because PMC prioritizes you. At PMC, we uphold a culture of kindness and accountability. We value diversity, inclusion, and provide support to team members. We promote a healthy work-life balance and encourage everyone to be their authentic selves at work every day.
What We Offer:
Work-Life Balance:
Competitive Benefits:
The Credentialing Specialist role is a crucial part of PMC's Telehealth division. This position involves managing and coordinating all functions related to credentialing and recredentialing healthcare providers and maintaining provider credentialing files.
Duties and Responsibilities
The Credentialing Specialist responsibilities shall include, but not be limited to, the following:
Qualifications
Physical Requirements
While performing your duties, you should expect to communicate effectively. Specific vision abilities required for this role include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
