TDB Communications is seeking a highly organized, self-motivated, and detail-oriented Credentialing Specialist to join our team. As a Credentialing Specialist for Physician Accreditation, you will be responsible for providing full-circle credentialing, to include employment and education verifications, coordination with the customer and provider to ensure our providers are expeditiously actioned to become billable. Your primary responsibility will be to work directly with the provider to collect, verify, and maintain accurate information related to providers' qualifications, licensure, certifications, and other credentials. You will collaborate with internal stakeholders and external entities to facilitate the accreditation process, ensure compliance with regulatory standards, and maintain the highest level of quality assurance.
Responsibilities:
Physician Credentialing: Oversee the entire credentialing process for providers within the organization, ensuring adherence to industry standards and regulatory requirements.
Verification and Documentation: Collect, review, and verify information related to providers' education, training, licensure, certifications, work history, malpractice history, and professional references. Maintain accurate and up-to-date records of all credentials.
Application Management: Prepare and submit timely and accurate credentialing applications to accrediting bodies, hospitals, insurance companies, and other relevant entities as required. Track application progress and follow up on outstanding items or requests for additional information.
Compliance and Quality Assurance: Ensure compliance with relevant accreditation standards, government regulations, and internal policies. Conduct periodic audits to ensure accuracy, completeness, and quality of credentialing files.
Communication and Collaboration: Serve as a liaison between providers, internal departments, and external entities to facilitate timely and accurate exchange of credentialing information. Collaborate with medical staff, HR, legal, and other teams to resolve any issues related to provider credentialing.
Credentialing Database Management: Utilize credentialing software systems or databases to maintain accurate records, track expirations of credentials, and generate reports as needed.
Continuous Improvement: Stay updated on industry trends, best practices, and regulatory changes related to physician credentialing. Recommend process improvements to enhance efficiency, accuracy, and overall quality of the credentialing process.
Qualifications:
Education: Bachelor's degree in healthcare administration, business administration, or a related field is preferred. Relevant experience or certifications in healthcare credentialing (e.g., Certified Provider Credentialing Specialist, Certified Medical Staff Services Professional) are a plus.
Experience: Minimum of 2-3 years of experience in physician credentialing or a related field, preferably within a healthcare organization or medical staff services department. Familiarity with accreditation standards such as Joint Commission (TJC), National Committee for Quality Assurance (NCQA), or Accreditation Council for Graduate Medical Education (ACGME) is highly desirable.
Knowledge: Strong understanding of credentialing and privileging processes, including knowledge of state licensing requirements, DEA registration, board certifications, and provider enrollment procedures. Familiarity with healthcare terminology, regulations (e.g., HIPAA), and CMS guidelines is essential.
Attention to Detail: Exceptional attention to detail and accuracy in reviewing and verifying complex credentialing documents and data. Ability to identify discrepancies, inconsistencies, and potential red flags.
Organizational Skills: Excellent organizational and time management skills to handle multiple tasks, prioritize responsibilities, and meet deadlines in a fast-paced environment.
Communication: Strong written and verbal communication skills, with the ability to effectively interact with physicians, internal stakeholders, and external entities. Professionalism and diplomacy in handling sensitive and confidential information.
Technology Proficiency: Proficient in using credentialing software systems, databases, and Microsoft Office applications (Word, Excel, Outlook). Ability to quickly learn new software and technology platforms.
Analytical Skills: Strong analytical and problem-solving abilities to assess credentialing applications, interpret regulations and standards, and make informed decisions.
Teamwork: Collaborative mindset with the ability to work effectively both independently and within a team environment.
If you are a highly organized individual with a keen eye for detail and a passion for maintaining the highest standards of physician accreditation, we encourage you to apply for the position of Credentialing Specialist.
About TDB
TDB Communications, Inc. is an 8(a)-minority-owned, service-disabled veteran-owned small business (SDVOSB). We support government agencies with a scalable workforce, program management, and information processing solutions.
Since 1999, we have deployed thousands of employees for 70 agencies in 30 states. We have proven our ability to serve the government with the highest levels of quality and productivity.
Reasonable Accommodation
TDB Communications, Inc complies with federal and state disability laws and makes reasonable accommodation for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, or to receive other benefits and privileges of employment, please contact your recruiter.
EEO Statement
TDB Communications, Inc is an Equal Opportunity Employer. All employment decisions at TDB are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.
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