Job Summary
The TM-Provider Credentialing role requires a seasoned professional with 10 to 12 years of experience in provider credentialing processes. The candidate will leverage their expertise in Facets - Provider and domain skills in Primary Source Verification and Credentialing Application Processing to ensure compliance and efficiency. This position is based in the office and operates during night shifts requiring proficiency in English.
Responsibilities
- Oversee the credentialing process to ensure all providers meet necessary qualifications and standards.
- Coordinate with various departments to streamline credentialing application processing.
- Implement best practices in Primary Source Verification to maintain high standards of accuracy.
- Utilize Facets
- Provider to manage and track credentialing data efficiently.
- Ensure compliance with regulatory requirements and industry standards.
- Provide detailed reports on credentialing status and progress to management.
- Collaborate with providers to resolve any credentialing issues or discrepancies.
- Develop and maintain documentation related to credentialing processes.
- Conduct audits to verify the accuracy and completeness of credentialing records.
- Train team members on credentialing procedures and system usage.
- Monitor industry trends to anticipate changes in credentialing requirements.
- Facilitate communication between providers and the organization to ensure smooth credentialing operations.
- Enhance the credentialing process to improve efficiency and reduce turnaround time.
Qualifications
- Possess strong expertise in Facets
- Provider to manage credentialing data.
- Demonstrate proficiency in Primary Source Verification to ensure accuracy.
- Exhibit comprehensive knowledge of Credentialing Application Processing.
- Have excellent communication skills in English for effective collaboration.
- Show ability to work efficiently during night shifts in an office setting.
- Display attention to detail and problem-solving skills in credentialing tasks.
- Maintain up-to-date knowledge of industry standards and regulatory requirements.
Certifications Required
Certified Provider Credentialing Specialist (CPCS) or equivalent certification relevant to credentialing processes.
