Physician Credentialing Specialist

Advanced College Modesto , CA 95351

Posted 3 months ago

POSITION SUMMARY

The Physician Credentialing Specialist is responsible for credentialing new providers and maintain current provider files for the growing multi-specialty physician group. They are responsible for submitting and tracking credentialing applications to various contracted insurances for oncoming providers. They will maintain the data for all providers within the group, track the expiration of certification and licenses, and will act as a liaison between hospital administration and medical staff, including physicians.

POSITION QUALIFICATIONS

  • At least three (3) years of medical services experience is preferred.

  • Knowledge of medical terminology, strong organization skills, good written communication skills, ability to work independently, and ability to conduct research while performing job duties is required.

  • The position also requires a person who is able to communicate well with all levels of staff, physicians, and patient referral sources.

  • He/she is flexible, responsible for assignments, and supportive of team efforts.

The duties and responsibilities are listed below. It is the expectation of the American Advanced Management that the employee be able to demonstrate competency in each area. It is the duty of the company to provide orientation and performance evaluation in each area stated.

DUTIES AND RESPONSIBILITIES

  • Ensures all necessary licenses and credentials are verified and updated for the facility

  • Conduct background checks

  • Contact licensing boards

  • Review license applications

  • Obtain education information

  • Complete references

  • Ensure the facility is operating within state and federal regulations

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Physician Credentialing Specialist

Advanced College