Credentialing Specialist

The Credentialing Specialist is an integral of the PPE, LLC professional team. Processing candidates and working with the Medical Staff Offices of our sites with a strong knowledge of physician credentialing, Joint Commission regulations and Medical Staff Office procedures and practices is the job of this position.

• Works with recruiter and Clinical Services staff to identify the needs and priorities as they relate to the staffing needs of individuals PPE sites.
• Handles all aspects of new business start-ups (sending offer letters and contracts to incumbents and newly recruited providers, providing HR & Payroll with paperwork to set up providers in our Company system, set up answering service for group, malpractice, etc.)
• Processes newly identified candidates by preparing applications and related paperwork to be sent to the candidate for completion and return.
• Reviews returned application for completion and accuracy and sends completed package to the appropriate Medical Staff Office for processing.
• Maintains accurate candidate information in physician database which is updated regularly with current credentials, address changes, status changes, etc.
• Liaisons with insurance credentialing staff to make sure they have necessary paperwork to credential practitioners with insurance companies for billing.
• Follows up regularly with Medical Staff Offices to assist in the credentialing process of new candidates and supplying any needed information on existing physicians (reappointment applications, updated credentials, etc.)
• Orders scrubs/lab coats and prescription pads for new practitioners as needed.
• Responsible for 24-hour emergency phone coverage for hospital sites.
• Review all payroll at month end before it goes to Payroll dept. for processing.
• Develops and maintains strong working relationships with client hospitals, company medical directors and internal colleagues.

Requirements

• Bachelor’s Degree and/or 2-3 years of hospital credentialing experience required
• Proficiency in MS Word, Excel and Access
• Excellent verbal and written communications skills
• Highly organized, detail oriented
• Ability to multi-task and prioritize is essential
• Must be able to work under pressure and deadlines
• Willing to take on new projects as needed
• Reports to Supervisor of Client Services