Credentialing Specialist

Full Time Benefit eligible position 

Hybrid telecommute option. Reside in Minneapolis/St. Paul area only.

Monday - Friday 40 hours per week 

Summary of Position:

The credentialing specialist is responsible for all aspects of the credentialing, recredentialing and privileging process for all medical providers who provide care with Midwest Radiology. Responsible for ensuring providers are credentialed, appointed, and privileged with hospitals and health plans. The credentialing specialist works directly with providers to maintain up-to-date data for each provider in the credentialing database, ensuring accuracy of credentialing applications, and timely renewal of licenses and certifications.

Essential Functions:

· Compile and maintain current and accurate data for all provider credentialing records.

· Maintain licenses, certification, health records, and CMEs for providers. Tracks expirations to ensure timely renewals.

· Completes provider initial and reappointment applications. Monitors applications and follow-ups as needed to support completion.

· Reviews credentialing applications for completeness and accuracy.

· Communicates with providers to collect and maintain up to date information required in a complete credentialing application and provider record.

· Performs verifications of credentialing records.

· Assist hospitals and health plans with information needed to maintain the provider’s credentialing files

· Respond to telephone and email in a timely manner.

· Ensures security and confidentiality of credentialing records is adhered to.

· Work closely with the credentialing manager to identify and resolve issues related to provider credentialing.

· Performs other related duties as assigned.

Knowledge and Skills:

· Maintain understanding of the credentialing process, best practices and applicable regulations.

· Ability to organize work and priorities to meet deadlines required of credentialing and recredentialing processes.

· Excellent verbal and written communication skills including, letters, memos, and emails.

· Ability to establish and maintain effective working relationships with providers, management, staff and contacts outside of the organization.

· Dependable – consistently at work and on time.

· Excellent attention to detail.

· Incorporate company values into daily interactions with internal and external customers.

Qualifications:

· High school diploma or equivalent.

· Associate’s degree preferred.

· Certified Provider Credentialing Specialist (CPCS) preferred.

· 2 years of experience in credentialing or similar medical business office role preferred.

· Must be able to work independently with minimal supervision.

· Proficient use of Microsoft Office applications (Outlook, Word, Excel) and internet resources.

· Demonstrate strong computer and data management skills.

Daily Physical Demands Required for Performing Essential Functions of the Job:

Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires lifting papers or boxes up to 30 pounds occasionally.

Environmental/Working Conditions:

· Work is performed in an office environment.

· It involves frequent contact, in person and on the telephone, with associates and the public.

· Work may be stressful at times. Contact may involve dealing with upset people.

Disclaimer:

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. The Company reserves the right to amend and change responsibilities to meet Company needs as necessary. The relationship of anyone in this position with the Company is at-will.

Summary:

Hybrid telecommute option. Reside in Minneapolis/St. Paul area only.

We offer 401K, Medical, Dental, Vision, Life and Disability insurance.