About NuView Health
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Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Boca Raton, FL, US
Year founded
2006
Job description
Job Type
Full-time
Description
Summary
The Credentialing Specialist is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing processes for NuView Health. This includes facilitating initial hospital appointments, reappointments, and the management of expirables, as well as completing medical licensing applications. The Credentialing Specialist ensures the accuracy and integrity of the credentialing database and related applications while maintaining compliance with all applicable standards and regulations.
Duties and Responsibilities
Requirements
Minimum Job Requirements
Knowledge, Skills and Abilities Required
Working Conditions and Physical Effort
Full-time
Description
Summary
The Credentialing Specialist is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing processes for NuView Health. This includes facilitating initial hospital appointments, reappointments, and the management of expirables, as well as completing medical licensing applications. The Credentialing Specialist ensures the accuracy and integrity of the credentialing database and related applications while maintaining compliance with all applicable standards and regulations.
Duties and Responsibilities
- Oversee and coordinate the onboarding process for new physicians and allied health professionals.
- Conduct comprehensive background checks, research, and primary source verification for all credentialing applications.
- Manage the entire credentialing and re-credentialing process for medical and allied health staff.
- Identify and resolve issues or discrepancies, ensuring thorough investigation and appropriate follow-up.
- Ensure timely and accurate processing and verification of credentials, licenses, certifications, and supporting documentation.
- Maintain effective communication with physicians and allied health professionals, leadership, and regulatory agencies regarding credentialing status and requirements.
- Assist hospital Medical Staff Offices with follow-up on outstanding verifications, ensuring timely file completion.
- Respond to inquiries from healthcare organizations and interface with internal and external clients on credentialing and privileging issues.
- Utilize the credentialing database for optimizing efficiency; perform queries, reporting, and document generation.
- Monitor and track expirables (licenses, certifications, etc.) for all medical staff.
- Prepare and review initial and renewal state medical license applications for practitioner submission.
- Perform other related duties as assigned.
Requirements
Minimum Job Requirements
- Education: Associate's or Bachelor's degree in Healthcare Administration, Business, or related field preferred.
- Experience: Minimum 2 years in medical staff credentialing or healthcare administration required; experience in an acute care or hospital setting preferred.
- Knowledge: Familiarity with medical credentialing and privileging procedures, standards, and regulatory requirements.
Knowledge, Skills and Abilities Required
- Strong organizational and time-management abilities; able to multi-task effectively.
- Excellent verbal and written communication skills.
- High attention to detail and accuracy.
- Proficiency in Microsoft Office Suite and credentialing software.
- Ability to work both independently and as part of a team.
- Knowledge of medical terminology, credentialing standards, and regulatory requirements.
- Strong problem-solving and reasoning abilities.
- Interpersonal skills to develop and maintain professional relationships.
- Program planning and implementation skills.
- Research and information-gathering skills.
- Ability to exercise independent judgment and maintain confidentiality.
- Database management skills, including querying, reporting, and document generation.
- Demonstrated initiative and proactive approach to responsibilities.
Working Conditions and Physical Effort
- Minimal to no exposure to physical risk.
- Minimal physical effort required.
- Work is performed in a standard office environment.
nuviewhealth.com
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Frequently asked questions
Q: What skills or qualities help someone succeed as a Credentialing Specialist?
A: To succeed as a Credentialing Specialist, key technical skills include proficiency in electronic health record (EHR) systems, knowledge of accreditation and certification standards, and expertise in data analysis and reporting. Soft skills such as strong communication, organizational, and problem-solving abilities are also crucial, as Credentialing Specialists must effectively collaborate with healthcare providers, verify credentials, and resolve discrepancies. By combining these technical and soft skills, Credentialing Specialists can efficiently manage credentialing processes, ensure compliance, and drive career growth through opportunities for professional development and leadership roles.
Q: What is the career path for a Credentialing Specialist?
A: A Credentialing Specialist's typical career progression involves starting as a Coordinator or Assistant, where they verify provider credentials and maintain accurate records, then advancing to a Specialist or Senior Specialist role, overseeing complex credentialing processes and leading teams. Key opportunities for skill development include learning healthcare regulations, developing strong analytical and communication skills, and staying up-to-date with industry standards and best practices. Long-term career prospects may lead to leadership positions, such as Director of Credentialing or Compliance Officer, or transition into related fields like healthcare administration or medical billing.
