Credentialing Specialist
Wellington Regional Medical Center
IPM Credentialing Specialist
Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.
Position Overview: The IPM Credentialing Specialist ensures that the credentialing requirements for governmental agencies and commercial managed care insurers/networks are met and managed timely so that physicians are enrolled in and maintain active credentialing status with such entities. They are also responsible for credentialing, as assigned, to other IPM physician group models.
Duties & Responsibilities:
- Submits and follow up on credentialing to all contracted commercial payors and government agencies timely and accurately.
- Supports other IPM locations with credentialing as needed and maintains close working relations with appropriate contacts to keep them well informed.
- Maintains appropriate tracking of time and promptly reports it on a weekly basis as established by the Credentialing Department.
- Enters and maintains data in the credentialing database, Intellisoft, according to established data entry rules and policies.
- Ensures that demographic changes to contracted physicians are promptly reported to all contracted managed care companies and government agencies.
- Performs database queries and reports as needed.
- Maintains managed care contract files (paper and electronic) and department databases for contracts and credentialing.
Qualifications:
- High School Diploma/GED required. Bachelor's degree preferred, but commensurate work experience in progressively responsible administrative positions will be considered.
- 3 5 years of experience with physician credentialing and/or physician contracting requirements in a managed care environment.
- Comprehensive knowledge of the managed care industry, with specific emphasis on physician credentialing and/or physician contracting requirements.
- A broad understanding of the managed care contracting process is required and knowledge of managed care payers' processes.
- Responsible for credentialing activities as it relates to initial credentialing, re-credentialing, and credentials modification.
- Ability to communicate effectively both verbally and in writing with internal departments, physicians, physician group management staff and managed care companies to achieve the necessary results required in the credentialing process and support of the Credentialing Department.
As an IPM employee you will be part of a first-class organization offering:
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- Tuition Reimbursement after 1 year of employment and much more!
Independence Shared Services is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee via email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of Independence Shared Services. No fee will be paid in the event the candidate is hired because of the referral or through other means.
About Universal Health Services: One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.
Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillsets and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: or View phone number on click.appcast.io
Wellington Regional Medical Center$60.5k
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