Credentialing Specialist

Description

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery.

The Credentialing Specialist is responsible for partnering with medical providers, hospitals, insurance companies, operations leaders and other stakeholders to ensure providers are credentialed. This position will manage all aspects of the hospital and financial credentialing processes for new hires and existing providers to include documentation, communication, monitoring, and staying abreast of credentialing specifications.  

Essential Duties: 

• Stay abreast of credentialing and recredentialing requirements for each client group 
• Requests, reviews, and verifies credentialing applications and supporting documentation 
• Establish and maintain database of provider details and credentialing data 
• Monitor license and certification expirations for providers to ensure timely renewals 
• Notify providers and administration of upcoming expirations and documentation requests 
• Collaborate with hospitals, insurance companies, and other stakeholders to extend information and track credentialing process 
• Provide status updates to operations leaders, providers, and other stakeholders 
• Resolve issues that arise and escalate when appropriate 
• Other duties as assigned 

Skills, Knowledge, Abilities: 

• Knowledgeable on credentialing requirements and workflows for providers at differing client groups 
• Familiar with healthcare jargon and terminology related to credentialing 
• Excellent verbal and written communication skills 
• Excellent interpersonal and customer service skills 
• Proficient in Microsoft Office and credentialing related software 
• Excellent organizational skills and attention to detail 
• Work independently and exercise judgement on decision making and issue resolution 
• Navigate competing priorities and effectively work in a fast-paced environment 
• Manage information flow in a timely and accurate manner 
• Collaborate with an array of professionals at various client groups and geographic locations 
• Identify and execute opportunities for improvement 
• Exhibit growth mindset and team-orientated behaviors 

Core Clinical Partners is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable. 

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. 

Requirements

Education: 

• High School Diploma or GED required 

Experience: 

• Prior administrative experience in a healthcare environment 
• Medical credentialing experience preferred 
• Experience with MS Outlook, Word, and Excel 
• Experience with MS Teams and credentialing software preferred