Credentialing Specialist

Summary

The role of Credentialing Specialist is a critical position for the credentialing department. The purpose of this position is to facilitate the timely completion and delivery of credentialing files as well as maintaining the databases used for the tracking and storage of credentials. The role of Credentialing Specialist requires extreme attention to detail, dedication to purpose, and an appropriate sense of urgency. A person succeeding in this role will bring a desire to enhance and improve existing systems and procedures through unique problem solving and time management techniques.

Duties and Functions

The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by our customers. File completion to include, but not limited to:

· Primary Source Verifications

· Employment Verifications

· Reference Verifications

· Maintain all credentialing tracking logs for providers currently working on assignment or in between assignments.

· Request and pursue obtaining copies of all required renewable credentials prior to their expiration.

· Reminders will be sent to providers at 90, 60 , and 30-day intervals and then weekly within the last 30 days prior to expiration.

· If a renewable credential cannot be obtained prior to expiration, specialist will communicate the deficit to the appropriate Program/Account Manager so that appropriate action can take place.

· Send copies of updated credentials to customers as directed, prior to expiration.

Education and Experience

Associate degree or equivalent with Healthcare Admin experience.

Preferred Requirements

One year or more of administrative experience, preferably in healthcare.

Knowledge/Skills/Abilities (KSA)

Knowledge—Basic understanding of healthcare terminology processes and strategies.

Skill/Ability

· Communicates and works well with others in a team environment. Good customer service and public relations.

· Knowledge of related computer applications including database entry.

· Excellent phone skills.

· Able to work well independently and in a team environment. Attention to detail and solid organizational skills.

· Ability to apply common sense understanding to carry out detailed but uninvolved instructions and to deal with problems involving a few variables.

· Competent in the use of MS Word and Excel.

Acknowledgement

Loyal Source does not discriminate in employment based on race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factors.

This job description is not an exclusive or exhaustive list of all job functions that an employee in this position may be asked to perform. All employees are required to perform the essential functions, physical demands and intended purpose of their role in a satisfactory manner.

I attest that I can perform the essential job functions as outlined in this job description with or without any reasonable accommodation(s). I understand if I want to inquire about or seek reasonable accommodations, I am required to contact Human Resources at [email protected].

I acknowledge that I have read and understand the essential job functions, work environment/conditions, exemption classification and physical demands set forth in the job description provided for my position.

This contractor and subcontractor abides by the requirements of 41 CFR 60-300.5(a) and 41 CFR 60-741.5(a).

These regulations prohibit discrimination against qualified individuals on the basis of protected veteran status or disability, and require affirmative action by covered prime contractors.