Credentialing Specialist Hybrid - 6+ Month Contract

Contract Duration: 6 months or longer. Potential for direct hire.
JOB SUMMARY:
As a Credentialing Specialist, you will play a pivotal role in managing managed care provider enrollment and hospital credentialing for physicians within a prominent multi-physician group located in Phoenix, AZ. This position entails overseeing credentialing processes for over 70 pathologists, ensuring compliance with various regulatory requirements and managing relationships with key stakeholders including government agencies and hospitals.
Essential Functions:

1. Coordinate physician credentialing processes, ensuring adherence to all relevant standards and guidelines.
2. Complete comprehensive hospital credentialing applications on behalf of physicians.
3. Address and resolve any credentialing issues that may arise with hospitals or other organizations.
4. Maintain accurate records of physician and office expirables, updating and scanning documents as necessary.
5. Manage and update physician credentialing database and shared files to ensure accuracy and accessibility.
6. Maintain current physician CVs to reflect relevant qualifications and experience.
7. Assist with group/provider liability insurance applications and renewals.
8. Generate reports to track credentialing status and related metrics.
9. Perform any other duties as required to support the efficient operation of the credentialing process.

Additional Functions:

1. Facilitate the onboarding process for new pathologists joining the organization.
2. Maintain records of CLIA certificates for all PSA and CPA clients.
3. Manage applications and updates for NPPES, PECOS, and CAQH information, ensuring compliance with revalidation requirements.
4. Serve as backup for phones and handle return consults and slides as needed.
5. Coordinate credentialing updates for PSA and CPA Executive Meetings.
6. Provide supervision, guidance, and training to the Hospital Credentialing Coordinator.
7. Complete hospital applications and reappointments as necessary.
8. Procure CPA and PSA printed materials such as business cards, letterheads, envelopes, and labels.
9. Ensure timely renewal of MICA liability and eMed insurance annually.

Minimum Qualifications:

• High school diploma or equivalent required.
• Experience with credentialing software preferred.
• Proficiency in MS Office and Outlook applications.
• Strong organizational skills with the ability to work independently and multitask effectively.
• Excellent communication skills and the ability to collaborate with colleagues and physicians.
• Commitment to maintaining strict confidentiality of information and files.

Equipment Used: Computer, scanner, fax machine, telephone.
Scope and Complexity: This position involves close collaboration with various personnel including pathologists, executives, managers, supervisors, and external individuals such as auditors and consultants. It requires meticulous attention to detail, the ability to function effectively in a high-stress environment, and strong analytical skills.
Physical/Mental/Visual Demands, Environment: This role requires excellent communication skills, analytical abilities, and the capacity to function effectively under pressure. The majority of tasks involve working at a computer station and using a telephone, with occasional lifting and bending required. Compliance with all safety policies and practices is essential.
 

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