Job Posted June 1, 2022

Credentialing Specialist

Opening with Proliance Surgeons, Inc.
Job Role: Administrative
Job Type: Part Time

Overview

Position Summary

The Delegated Credentialing Specialist will handle all facets of delegated provider credentialing. Part-time (20 hours/week) remote position for only those candidates living full time in Washington, Tennessee or Rhode Island.

• Coordinate all managed care credentialing activities to ensure provider participation status
• Maintain necessary logs, lists, records, and current documentation required for physician/provider credentialing and re-credentialing
• Maintain necessary records of outstanding submissions and requests
• Verify physician/provider information by searching third party databases
• Maintain familiarity and stay current with NCQA guidelines
• Research and solve credentialing/re-credentialing problems.
• Provides highest level of customer service for both internal and external customers
• Have a thorough understanding of company policy and processes, being able to adjust to fast paced, ever changing demands of the insurance industry in or to always be up to the minute with the latest information
• Ability to prioritize tasks and projects assigned to staff to meet deadlines and, the discretion to know when to act independently and when to ask for guidance and/or assistance
• Remains current on policies affecting provider credentialing
• Performs MDStaff/MDApp database and computer functions as required
• Perform a variety of routine clerical functions and projects as assigned

• Highly self-motivated, with experience in healthcare licensed provider credentialing, expirables management and re-credentialing
• Success-driven and results-oriented, with the ability to implement and manage cross-functional projects
• Proficiency with credentialing systems and learns new systems/processes quickly
• Ability to interact effectively with a variety of people and be an excellent “ambassador” for the company
• Strong written and verbal communication skills, along with strong presentation and client interaction skills
• Ability to prioritize tasks and projects
• Accurate discernment on when to act independently and when to ask for guidance and/or assistance
• Consistently demonstrates flexibility, a customer-focus, terrific organizational skills and a passion for details

• High school diploma or GED required; Bachelor’s Degree is preferred
• Two years of provider credentialing and/or experience in the healthcare industry is required
• Experience with MDStaff/MDApp a plus

• The work environment/physical demands described here are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions.
• Work is performed in a remote environment. Requires corrected vision and hearing to normal range. While performing the duties of this job, the teammate is regularly required to talk or hear. Required to sit for long periods of time, stand and walk, bend and stretch. Use of telephone and computer is required. Manual dexterity required for use of computer keyboard.
• This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.

The work environment/physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.

How we are protecting team members from COVID-19?
Employee and patient health and safety is our top priority. At Proliance, we are adhering to CDC, State and local orders regarding COVID-19 and have implemented processes and precautions across our facilities to prevent the spread of COVID-19.

Following the most recent vaccination mandate for healthcare workers in Washington State, and our commitment to the health and safety of our employees and patients, all Proliance employees will be required to provide proof of full vaccination upon hire, or proof of a medical or religious exemption.

Proliance Surgeons offers a generous benefits package including Medical/RX, Dental, Vision, 401k with profit sharing and more! Plus ALL of our employees enjoy the free perks of our employee purchasing program offering a variety of discounts on purchases made every day – including cell phone service!


Proliance Surgeons is proud to be an equal opportunity employer. We are committed to creating an inclusive environment, and we welcome and encourage people of all backgrounds, perspectives, experiences, and skills to apply.


All employment decisions at Proliance Surgeons 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. We will not tolerate discrimination or harassment based on any of these characteristics. 

Care Center

805 Madison St Suite 901
Seattle, WA 98104

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