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Credentialing Specialist

Mpower Health

Credentialing Specialist

San Antonio, TX
Full Time
Paid
  • Responsibilities

    We are looking for a positive person who is interested in being a success and will help take the company to the next level. Mpower Healthcare, culture calls for superior customer service, excellent understanding of best practices in credentialing and a commitment to team problem solving and solutions. The seasoned professional for this job need superior communication and computer skills including strong familiarization with the Joint Commission credentialing processes, Microsoft Outlook, Word, and Excel are essential.

    Essential work skills and Responsibilities

    • Knowledge of federal and state regulatory requirements and accreditation standards (i.e., Joint Commission, CMS)

    • Maintain, track and update all credentialing documents, including checking all applications for accuracy and completeness and providing status to need-to-know parties in a timely manner.

    • Completes initial and re-credentialing applications on all physicians

    • Update and maintain all licensures, CVs, DEA’s and certificates

    • Tracks expiable information for all providers to ensure timely renewals.

    • Maintains excellent working relationships with the facilities to ensure the timely and accurate credentialing status

    • Maintains strict confidentiality with regard to protected health information understands HIPAA Privacy & Security policies and procedures

    • Maintains strict confidentiality regarding provider information.

    • Performs other duties and special projects as assigned by Supervisor or Director

    Skills and Abilities

    Able to perform all essential duties with or without accommodations, including but not limited to:

    • Knowledge of Joint Commission Standards

    • Proficient and accurate in data entry.

    • Ability to prioritize workload and meet strict deadlines.

    • Strong problem-solving skills and attention to detail.

    • Ability to prepare and write reports, summaries of work/work projects.

    • Strong personal motivation with ability to work with little supervision and attention to

    detail while working in a deadline-driven environment.

    • Ability to think creatively, highly driven, self-motivated, highly organized.

    • Ability to courteously work with medical staff, hospital staff, the insurance company representatives, co-workers, and others

    • Familiar with Texas Standardized Credentialing Application

    • Familiar with the verification process

    • Familiar with the ability to apply a physician to a Licensing Authority

    Experience and Training

    • High School Diploma or GED

    • Minimum of two years’ experience in credentialing

    • Excel, Word, Adobe experience

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