Credentialling Administration Support Specialist

Summary/objective 

The Credentialing and Administration Support Specialist is responsible for verifying the qualifications and credentials of healthcare professionals, such as physicians and nurses, to ensure compliance with regulations and organizational standards. Key tasks include reviewing applications, conducting background checks, managing schedules, handling correspondence, organizing files, and coordinating meetings. They also assist with data entry, prepare reports, may handle customer inquiries and maintaining accurate records. 

Essential functions 

Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. 

• Verify the credentials of healthcare providers, including educational background, licensure, certifications, training, and work history 

• Process and review applications for medical staff. Ensure that all required documentation is complete and accurate before submission for approval. 

• Maintain and update credentialing databases and records, ensuring they are accurate and current. 

• Track expiration dates for licenses, certifications, and other credentials, and initiate renewal processes as needed. 

• Assist with the onboarding process for new healthcare providers, including ensuring that all credentialing requirements are met before they begin practicing. 

• Answers/screens phone calls and voice messages and transfers to appropriate personnel as necessary 

• Assists with generating monthly financial reports and other reports 

• Ability to handle classified and confidential information and practice discretion 

• Retrieves information as requested from records, emails, minutes, and other related documents; prepares written data summaries when needed 

• Responds to and resolves administrative inquiries and questions 

• Coordinates and schedules travel, meetings, and appointments for managers or providers 

• Prepares agendas, documents, and minutes for meetings 

• Assists with ordering and maintaining office supplies and equipment 

• Processes incoming mail and other documents directed to the administrative team 

• Assist with medical records requests 

• Performs other related duties as assigned 

• Assists with referral management and administration 

• Obtain and accurately document patient demographic and insurance information 

• Identify scheduling inefficiencies and recommend process improvements to leadership 

• Facilitate communication between care teams by managing inbound and outbound calls, emails, and faxes at our call center 

• Ensure compliance with scheduling policies, patient privacy standards, and HIPAA requirements 

• Enter clinical messages and patient inquiries into the electronic health record (EHR) system with accuracy and timeliness

Competencies 

• Ability to thrive in a fast-paced environment 

• Excellent customer service and computer skills 

• Strong verbal and written communication skills 

• Friendly, personable demeanor 

• Detail oriented 

Required education and experience 

• Highschool diploma or GED 

• Experience in credentialing or privileging within a healthcare setting is preferred 

Preferred education and experience 

• Experience in credentialing or privileging within a healthcare setting is preferred