Physician Credentialing Specialist

Physician Credentialing Specialist, Chicago Loop (Contract to hire)

Our client, that provides physician management services on behalf of the U of IL Physician Group, has an immediate staffing need for an experienced t-h, full-time Physician Credentialing Specialist. This is an on-site position in the central Chicago Loop. Once converted to the client’s payroll after 6-8 months you will be able to work remote.

Hours: M-F (8:00am to 4:30pm)

Duties:

The Credentialing Specialist provides coordination of the physician, practitioner and facility applications for initial credentialing and re-credentialing processes according to standards of the Nat. Committee on QA & regulatory requirement. Process Physician Credentialing applications for government payers in addition to maintaining provider files for license renewals as needed.

• Coordinating and monitoring the credentialing and re-credentialing review process for the Physician Group with governmental payers.
• Interacting with various depts as necessary to complete each Department’s Physician Credentialing application and documentation.
• Coordinating and monitoring new physician application processes until said application is deemed “complete” with PECOS and IMPACT.
• Maintain internal clinician roster & track progress of applications with payers.
• Partner with Managed Care Dept. for enrollment updates.
• Maintain active databases of contacts as primary resource.
• Review EPIC credentialing work queue to ensure charges being held for credentialing process to be completed by Medicare, Railroad, Medicaid, and Medicaid Managed Care are released as soon as credentialing approval is received from payers.
• Responding to claim denials related to credentialing issues and request necessary reports.
• Communicate issues for escalation to Client Services management.

Knowledge, Skills & Abilities:

• Knowledge of healthcare terminology, office procedures.
• Attention to detail w/the ability to identify/resolve problems & document the outcome.
• Strong communication and organization skills & ability to work independently.
• Solid, strong analytical and problem-solving skills.
• Goal-oriented – holds themselves accountable to achieving shared and personal goals.
• Establish effective working relationships with employees, patients and external vendors.
• Advanced skills with Microsoft Office applications: Word and Excel.

Education/Experience:

• Minimum 3-5 years’ exp. w/provider credentialing processes
• Exp. in healthcare financial analysis, revenue cycle processes, denials strongly desired.
• Ability to demonstrate problem solving, analytical, oral and written communication skills,
• Ability to engage in multiple initiatives simultaneously.
• Working knowledge of EPIC software and EPIC reporting instruments is required.
• Proficient in MS Office software including Visio, Word, Excel, and PowerPoint.

If you or anyone you know is qualified, immediately available and interested please sent resumes to us for immediate consideration.