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Medical Credentialing Specialist (Senior)

Metro Vein Centers West Bloomfield Township, MI
  • Posted: over a month ago
  • $50,000 to $65,000 Annually
  • Full-Time
  • Benefits: Vision, Medical, Life Insurance, 401k, Dental

Metro Vein Centers is seeking a Senior Credentialing Specialist for immediate hire. The Senior Credentialing Specialist oversees the credentialing process, manages the credentialing team, and supports the credentialing and re-credentialing processes for applicants and members of the Medical Staff. Initial applications and reappointment applications are processed in accordance with established policies, rules and regulations, bylaws, and regulatory governmental standards thereby ensuring that only qualified practitioners provide care within BHSF. The Junior Credentialing Specialist professionally directs health care providers in verifying their credentials and obtaining appropriate privileges. He/she will participate in projects initiated to facilitate the credentialing and verification tasks. The Senior Credentialing Specialist reports to the Chief Medical Officer.

Duties:

  • Perform primary provider source verifications of license, Drug Enforcement Administration (DEA) number, hospital affiliation, board certification status, malpractice history and sanction activity through various web-based agencies and sources
  • Research and summarize provider’s malpractice history for review
  • Enter and review provider information in systems; prepare reports as needed
  • Confirm authenticity of documents and ensure pre-established criteria have been met; return provider applications that do not meet criteria
  • Verify and review provider applications, participation agreements, or designations of provider groups
  • Follow up with providers regarding missing or expired information in credentialing application or documentation
  • Check provider status files for duplicate or conflicting information
  • Perform statistical analysis
  • Additional duties as assigned

Qualifications:

  • High School Diploma or GED required; four-year degree preferred
  • Minimum eight (8) administrative experience in a general office environment
  • Minimum five (5) years credentialing experience in a private practice environment
  • Experience with Provider Relations’ practices, business processes and credentialing databases
  • Basic skill level in Microsoft Word and Excel required
  • Experience with Google Suite and other cloud products
  • Excellent interpersonal and communications skills - both written and verbal
  • Strong analytical, problem-solving, time management, planning and organizational skills
  • Must possess excellent critical thinking and analytical capabilities; excellent attention to detail and accuracy
  • Ability to work well under pressure to meet deadlines and able to multi-task effectively and follow through on assignments to completion
  • Must be able to work well independently with minimal supervision, able to exercise good judgment and be a team player
  • Ability to establish and maintain effective working relationships with providers, staff, and other agencies

Metro Vein Centers

Why Work Here?

Endless growth potential. Fun, yet challenging environment. Chance to shine and make your mark. Diverse and welcoming staff.

Metro Vein Centers is a preeminent organization in the treatment of vein disease and other vascular disorders. With over twenty clinics, Metro Vein Centers provides cutting edge and compassionate care to its patients in six states. Working at Metro Vein Centers are over two dozen physicians, multiple mid-level providers, dozens of vascular technologists, and many more support staff in the form of medical assistants, patient care representatives, and other clerical staff. The organization’s mission is to provide cutting edge and compassionate care to patients suffering from vein disease and other vascular disorders, while maintaining a professional and successful business model which is constantly seeking growth opportunities.

Address

West Bloomfield Township, MI
USA

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