The Credentialing Specialist is responsible for managing the credentialing and re-credentialing process for healthcare providers within the organization. This role ensures that all healthcare professionals meet the necessary standards and comply with regulations to provide medical services. The Credentialing Specialist works closely with various departments to maintain accurate and up-to-date records of provider credentials.
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Responsibilities:
Credentialing Management: Oversee the initial credentialing and re-credentialing process for all healthcare providers, including physicians, nurses, and other medical staff.
Documentation: Collect, review, and verify all necessary documentation, including licenses, certifications, education, work history, and malpractice coverage.
Compliance: Ensure compliance with all applicable federal, state, and local regulations, as well as organizational policies and standards.
Database Maintenance: Maintain and update credentialing databases and systems to ensure accurate and current information.
Communication: Liaise with healthcare providers, insurance companies, and regulatory bodies to facilitate the credentialing process.
Problem Resolution: Address and resolve any issues or discrepancies related to provider credentials.
Reporting: Prepare and present reports on credentialing activities and status to management and relevant committees.
Audits: Assist with internal and external audits of credentialing processes and records.
Working hours: 8:00 AM - 5:00 PM
Skills:
Excellent organizational and time management abilities.
Strong attention to detail and accuracy.
Proficiency in using credentialing software and databases.
Excellent communication and interpersonal skills.
Ability to work independently and as part of a team.
Problem-solving and critical-thinking skills.
Education:
High School
Experience:
1-4 years
Qualifications:
Highschool degree or GED
Past experience in Credentialing for providers in a medical setting
Must be able to type 30 to 40 WPM
1 to 2 years experience in a medical setting
Strong communication skills
Attention to detail
Medical terminology
Must live in South Texas from Brownsville, Texas to McAllen, Texas
If interested and meet requirements apply online or text CRED to (956) 688-9333
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Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).