Credentialing Specialist

IPM Credentialing Specialist

Independence Physician Management (IPM) develops and manages multi-specialty physician networks and urgent care clinics within the Acute Care and Behavioral Health Divisions. A subsidiary of UHS, IPM operates in 13 markets across 7 states – and counting. 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.

Job duties include submitting and following up on credentialing to all contracted commercial payors and government agencies timely and accurately. They support other IPM locations with credentialing as needed and maintain close working relations with appropriate contacts to keep them well informed. They also maintain appropriate tracking of time and promptly report it on a weekly basis as established by the Credentialing Department. The specialist enters and maintains data in the credentialing database, Intellisoft, according to established data entry rules and policies. They ensure that demographic changes to contracted physicians are promptly reported to all contracted managed care companies and government agencies. They perform database queries and reports as needed. Managed care contract files (paper and electronic) and department databases for contracts and credentialing are also maintained.

Benefits include a 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, career development opportunities within UHS and its 300+ subsidiaries, and pet insurance. More information is available on our Benefits Guest Website.

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.

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.