Credentialing & Licensing Specialist III

Job Description Summary

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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.

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How will you make an impact & Requirements

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• 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.