What are the responsibilities and job description for the Credentialing Specialist position at PHHI?
Company Description
At Premier Healthcare Holdings Inc. (PHHI), we specialize in connecting healthcare professionals with rewarding opportunities that align with their skills and passion. Our mission is to ensure that healthcare facilities have access to top talent, enabling them to deliver exceptional care to their patients. We are dedicated to uniting talent with care to enhance the quality of healthcare services.
Role Description
The Credentialing Specialist is responsible for requesting, verifying, organizing, and maintaining all aspects of a clinician’s employee file. They work closely with clinicians and vendors to collect the necessary clinical and medical documentation by established deadlines. As the main point of contact for credentialing-related matters, they ensure that clinicians are cleared to begin their assignments on time. The specialist also ensures compliance with company credentialing requirements and policies. They maintain professional relationships with clinicians, clients, vendors, and colleagues, and keep managers and team members informed of progress and documentation updates.
Qualifications
- Evaluate clinician files to identify missing items and ensure all necessary documentation is on file.
- Guide clinicians through the credentialing process, acting as the main point of contact for all credentialing-related matters.
- Work with clinicians to obtain required new hire paperwork and credentialing documentation to ensure assignments start on time.
- Collaborate with external vendors to register clinicians for necessary occupational health items, competency testing, and other required certifications.
- Set up direct pay and complete medical facility authorizations as needed.
- Conduct background checks, licensure verifications, and education/employment verifications for clinicians.
- Escalate any questionable documentation (e.g., background checks, drug screens, disciplinary actions, or license issues) for review and approval.
- Receive, upload, and track all documents in the database and follow up with clinicians for any necessary updates.
- Resolve issues, inquiries, and concerns quickly and efficiently.
- Proactively communicate with both internal and external stakeholders to ensure smooth processes.
- Provide exceptional customer service to clinicians, ensuring all documentation is completed on time and preventing delays in assignment starts.
- Outline and organize the steps and documentation required for client credentialing.
- Coordinate and ensure all necessary documentation is in place for client credentialing.
- Prepare and structure documentation and procedures for client credentialing.
- Ensure team members supporting clients have the resources and support they need to complete credentialing successfully.
- Provide training as needed to support the department’s goals.
- Review Joint Commission, client, and company requirements to determine the necessary documentation for a complete file.
- Perform additional duties as assigned.
Knowledge, skills, and abilities:
- Ability to exhibit Company Values at all times.
- Working knowledge of Microsoft Office Software
- Strong customer service mindset
- Strong organizational and time management skills
- Ability to work independently and in a team environment.
- Ability to multi-task and reprioritize as new projects arise.
- Able to follow up and escalate items, per policy.
- Excellent problem-solving skills
- Strong attention to detail and accuracy
Education and Experience:
- High School Diploma or equivalent required; Bachelor’s degree preferred
- At least 2 year(s) of credentialing or related experience is preferred.
Premier Healthcare Holdings, Inc. and its affiliates provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.