Credentialing Specialist

Job Type


Full-time

Description

Summary

The Credentialing Specialist is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing processes for NuView Health. This includes facilitating initial hospital appointments, reappointments, and the management of expirables, as well as completing medical licensing applications. The Credentialing Specialist ensures the accuracy and integrity of the credentialing database and related applications while maintaining compliance with all applicable standards and regulations.


Duties and Responsibilities

• Oversee and coordinate the onboarding process for new physicians and allied health professionals.
• Conduct comprehensive background checks, research, and primary source verification for all credentialing applications.
• Manage the entire credentialing and re-credentialing process for medical and allied health staff.
• Identify and resolve issues or discrepancies, ensuring thorough investigation and appropriate follow-up.
• Ensure timely and accurate processing and verification of credentials, licenses, certifications, and supporting documentation.
• Maintain effective communication with physicians and allied health professionals, leadership, and regulatory agencies regarding credentialing status and requirements.
• Assist hospital Medical Staff Offices with follow-up on outstanding verifications, ensuring timely file completion.
• Respond to inquiries from healthcare organizations and interface with internal and external clients on credentialing and privileging issues.
• Utilize the credentialing database for optimizing efficiency; perform queries, reporting, and document generation.
• Monitor and track expirables (licenses, certifications, etc.) for all medical staff.
• Prepare and review initial and renewal state medical license applications for practitioner submission.
• Perform other related duties as assigned.

Requirements

Minimum Job Requirements

• Education: Associate's or Bachelor's degree in Healthcare Administration, Business, or related field preferred.
• Experience: Minimum 2 years in medical staff credentialing or healthcare administration required; experience in an acute care or hospital setting preferred.
• Knowledge: Familiarity with medical credentialing and privileging procedures, standards, and regulatory requirements.

Knowledge, Skills and Abilities Required

• Strong organizational and time-management abilities; able to multi-task effectively.
• Excellent verbal and written communication skills.
• High attention to detail and accuracy.
• Proficiency in Microsoft Office Suite and credentialing software.
• Ability to work both independently and as part of a team.
• Knowledge of medical terminology, credentialing standards, and regulatory requirements.
• Strong problem-solving and reasoning abilities.
• Interpersonal skills to develop and maintain professional relationships.
• Program planning and implementation skills.
• Research and information-gathering skills.
• Ability to exercise independent judgment and maintain confidentiality.
• Database management skills, including querying, reporting, and document generation.
• Demonstrated initiative and proactive approach to responsibilities.

Working Conditions and Physical Effort

• Minimal to no exposure to physical risk.
• Minimal physical effort required.
• Work is performed in a standard office environment.