Job Description Summary
The Credentialing & Licensing Specialist is responsible for linking and/or updating physician and mid-level providers with contracted insurance carriers. S/he also assists in staff privileges at area hospitals and nursing homes. S/he maintains current accurate information for the physicians and mid-level providers in MPG's database, with insurance carriers, and facilities. S/he will assist the Business Services teams as necessary.
How will you make an impact & Requirements
- Responsible for new and existing applications and reappointment paperwork is complete, accurate and timely including tasks required for exiting providers.
- Collects and processes verification and accreditation information for all physicians and mid-level providers associated with insurance carriers.
- Tracks and renews physician and mid-level provider licensure as approved.
- Maintains professional and open communication with physicians, mid-level providers and individuals within MPG to ensure up to date and consistent record keeping. Ensures all provider files are current with Human Resources.
- Demonstrates proficiency in Microsoft Word, Excel, and software unique to credential (i.e. Intellisoft) or hospital on-line application processes.
- Use PRactice Management System, Credentialing software and relevant portals as needed to fulfill job responsibilities and/or other associated assignments.
- Keeps supervisor fully informed regarding job responsibilities and challenges to success.
- Demonstrate excellent interpersonal and communication skills.