What are the responsibilities and job description for the Credentialing Specialist position at Dermatology Partners?
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Our Core Values Are
The Credentialing Specialist position is responsible for ensuring that healthcare providers are properly credentialed and in compliance with all regulatory and organizational standards. This role involves verifying the credentials, licensures, certifications, and background of medical professionals to maintain compliance with industry standards and legal regulations.
Responsibilities Include
Discover the Benefits of Joining Dermatology Partners!
- No Nights or Weekends
- Growth Opportunity
- Medical, Dental, and Vision Insurance
- PTO & Paid Holiday’s
- 401 (k) with 4% employee match-Fully Vested from day 1
- Company paid Life Insurance
- Options of additional Life insurance, Short & Long term disability, Critical Illness and Accident Insurance
- Employee Discount
- Referral Bonus
- Employee Appreciation Day: Dorney Park in Fall
- Employee Assistance Program (EAP)
Our Core Values Are
- Grow Together
- Seize Opportunity from Struggle
- Outcome Over Ego
- Commitment to Serve
- Do The Right Thing
The Credentialing Specialist position is responsible for ensuring that healthcare providers are properly credentialed and in compliance with all regulatory and organizational standards. This role involves verifying the credentials, licensures, certifications, and background of medical professionals to maintain compliance with industry standards and legal regulations.
Responsibilities Include
- Credential newly hired clinicians with applicable insurance payers for timely billing.
- Collect, Submit, & Track all necessary documentation.
- Process re-credentialing for existing clinicians as required by individual payers.
- Maintain a current, accurate database of all clinicians’ credentialing / licensure status, needs, expirations, issues, etc. Share with internal staff as applicable.
- Communicate & Coordinate with all levels of internal staff & external stakeholders to ensure timely & consistent qualification is met & maintained.
- Monitor expiring credentials to ensure ongoing compliance with regulatory guidelines.
- Investigate and resolve any issues that arise during the approval process.
- Under the direction of leadership, assist with site level enrollments or changes to contract.
- Other duties as deemed necessary.