Description

Our World-Class Team Begins with YOU!

Barrow Brain and Spine is a physician-owned specialty practice focused in the areas of neurosurgery and advanced spine care. The practice encompasses 27 neurosurgeons, three physiatrists and performs more than 8,000 surgeries each year. This globally recognized group directs the Neurosurgery Residency Program at St. Joseph’s Hospital in Phoenix, Arizona and serves more than 21,000 patients per year.

Do you have what it takes to be part of our World-Class team?

At Barrow Brain and Spine, each team member is dedicated to the highest levels of performance, integrity, collaboration, and commitment to patient care. These are not just words on a page, this is our culture. If you are looking for an extraordinary work environment dedicated to enhancing the lives of our patients and team members, we look forward to hearing from you.

Job Information

The Physician Credentialing Specialist is responsible for credentialing and re-credentialing the group’s healthcare providers as well as ensuring enrollment with participating group health plans, hospitals as well as provider license renewals. Credentialing functions include, but are not limited to, processing credentialing applications, performing primary source verifications, updating, and maintaining credentialing databases/spreadsheets and following all state and federal guidelines. This position would also assist the Medical Group Administrator in scheduling physician candidate interviews and dinners.

Essential Duties and Responsibilities:

• Initiate and support the practitioner application process by completing provider applications, sending, receiving, and analyzing practitioner documents and data to determine completeness in preparation for submission of applications.
• Responsible for gathering, verifying, and evaluating highly confidential and sensitive health care practitioner credentials consistent with departmental guidelines and accreditation standards.
• Efficiently perform all aspects of credentialing verification, including initial credentialing and 

re-credentialing to ensure current credentials and timely submission of practitioner files.

• Maintaining and upkeeping insurance information that is posted on the medical group databases and directories.
• Respond to all practitioner, client health plans and internal inquiries in a timely manner.
• Monitor expiring licensure, board and professional certifications and other expirable documents. 
• Maintain practitioner internal electronic data files as well as their CAQH applications to submit practitioner data as required to credential individual practitioners.
• Responsible for timely, accurate and complete data entry to ensure the integrity of credentialing information in applicable database(s)
• Collaborate with participating clients, department manager and/or external agencies to facilitate and ensure smooth hand-off during the credentialing process.
• Use critical thinking skills to conduct follow-up with individual practitioners and internal and 

external entities to resolve discrepancies identified during the credentialing process.

• Actively participates in team meetings and process improvement initiatives to continuously develop and implement process improvements for quality and efficiency.
• Shared responsibility for reviewing, processing, and distributing incoming correspondences (i.e., interdepartmental mail, fax and email)
• Keep Manager informed of potential credentialing or enrollment issues.
• Periodic Provider Directory updates to insurance companies
• Coordinate and schedule meetings.
• Maintains Medical Group records, meeting agendas and minutes as requested. 
• Catering assistance by ordering food for events and meetings
• Other duties as assigned.

Education & Experience:

• Associates degree is preferred; or, an equivalent combination of education and/or experience
• Minimum of 5 years’ experience in provider credentialing 
• Knowledge of medical credentialing and privileges procedures and standards
• Proficiency with MS Office and Excel

Qualifications:

• Certified Provider Credentialing Specialist (CPCS)
• Able to communicate clearly and concisely, both verbally and in written correspondence
• Able to work well under tight deadlines and respond to rapidly changing demands and provide efficient follow-up with minimal supervision.
• Sensitive and confidential information with discretion and trust

Comp & Benefits:

We offer a comprehensive compensation package. This includes benefit offerings you’d expect to see at a large company, all designed to help you take good care of yourself and your family. The benefits include:

• Choice of two medical plans – HRA, HDHP/HSA options
• Dental and Vision plan
• Disability – short-term & long-term, 100% employer paid
• Basic Life/AD&D, 100% employer paid
• Voluntary Life/AD&D available for employee, spouse, and children
• Voluntary Critical Illness and Accident coverage
• Generous Paid Time Off
• Paid Holidays

Barrow Brain and Spine is proud to be an equal opportunity workplace.

Preferred method of response is via our Careers page: (Careers and Job Postings at BarrowBrainandSpine.com)