Medical Staff Credentialing Specialist jobs in Nashua, NH
Medical Staff Credentialing Specialist processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist handles and resolves inquiries regarding credentialing information, process, or status. Requires a high school diploma. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor. The Medical Staff Credentialing Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Medical Staff Credentialing Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Recently Added Medical Staff Credentialing Specialist jobs
Provider Credentialing Specialist
- DMC Primary Care
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Windham, NH
FULL_TIME
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DMC Primary Care, a physician-owned, independent practice, with offices throughout southern New Hampshire, has been providing comprehensive care for entire families since 1964. We help each patient achieve the best possible health through every stage of life. We do this by providing an accessible, innovative healthcare experience that is built around our patient’s needs.
We are hiring a Provider Credentialing Specialist. This is a full-time position in Windham, NH.
The Provider Credentialing Specialist is responsible for overseeing and coordinating DMC’s onboarding and credentialing process for new providers and ongoing revalidation. The credentialing specialist will acquire primary source information necessary for DMC employment, as well as both initial and reappointment application or verification with all contracted health plans to ensure that all physician and non-physician provider requirements are met.
DUTIES INCLUDE:- Maintaining a thorough understanding of federal and state regulations, payer policies, and requirements in order to ensure a compliant provider employment and credentialing process for Derry Medical Center
- Performing the credentialing and privileging process in accordance with all governmental and commercial payer credentialing applications
- Collaborating closely with the Director of Human Resources and Medical Staff Coordinator to assist with DMC’s provider onboarding process
- Tracking and following up on physicians’ initial application/onboarding process and reappointment applications by performing primary source verification, preparing agency correspondence, and tracking responses within the organization’s provider database
- Maintaining individual provider files with up to date information and completes the revalidation requests issued by all governmental and commercial payers, as well any other DMC employment requirements
- Working with necessary individuals—including physicians, Human Resources, other professional staff, and their office or clerical staff—to acquire necessary materials and information for provider certification and licensure
- Assisting in filling out and reviewing credentialing applications and other employment requirements with practitioners and other applicable staff
- Notifying applicants when further information is requested regarding their background, training, demonstrated ability, previous performance, current competence, physical and mental health status, continuing education, etc.
- Maintaining accurate provider profiles on CAQH, PECOS, CMS, and other necessary databases
- Safeguarding the integrity of privileged information, credentialing and employment files in a professional and sensitive manner
- Identifying sanctioned providers on state and federal disciplinary action reports and initiates the requisite corrective processes to address cited violations
- Querying the National Practitioner Data Bank as needed, and does so in compliance with the Healthcare Quality Improvement Act (HCQIA)
- Remaining compliant with and knowledgeable of rules and regulations set forth by the Health Information Portability and Accountability Act (HIPAA), Joint Commission standards, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid Services, as well as state regulations— and relays this information to the necessary parties to ensure ongoing compliance organization-wide
- Providing all office visitors, credentialing contacts, payer representatives, and agency intermediaries with excellent customer service
- Collaborating with the billing department to help resolve and denials or authorizations issues related to provider credentialing
- Assisting the department manager and related staff with additional administrative tasks as needed
- Continuously seeking out further information and education through appropriate resources and references approved by management to research accurate answers and guidance for role and responsibilities. This includes maintaining any necessary reference guides, policies, procedures, FAQs, etc as a resource and reaching out to management and or other appropriate individuals for guidance when research performed does not provide an appropriate resolution
- Possessing high-level organizational skills and the ability to multi-task and work under pressure, while presenting a calm, professional manner and positive attitude
EDUCATION & TRAINING:- High school diploma or equivalent required
- At least two years of experience in healthcare provider credentialing required
- Proven experience working directly with healthcare personnel, such as physicians, in an office setting required
- Experience with Microsoft Office Suite (Word, Excel, Outlook, etc)
- Training, education, or certification in practitioner credentialing preferred
- Competitive hourly salary
- Comprehensive medical/dental benefits at 32 hours
- Paid time off
- 401K
For more information, please visit www.DMCPrimaryCare.com.
We are an equal opportunity employer embracing the strength that diversity brings to the workplace. We provide a welcoming and supportive environment for employees of all ethnic backgrounds, cultures, ages, lifestyles and physical abilities.
- 1 Month Ago
Credentialing coordinator
- Medicus Healthcare Solutions
-
Windham, NH
FULL_TIME
- The Opportunity : Reporting into the Credentialing Team Lead, the Credentialing Coordinator will be responsible for organizing, maintaining, and verifying all aspects of the credentialing process, ens...
- 15 Days Ago
Manager Medical Staff Services
- Clinical Management Consultants
-
Nashua, NH
FULL_TIME
- An award-winning critical access hospital located in southern New Hampshire is currently searching for an experienced Manager Medical Staff Services to join their dynamic healthcare team. This regiona...
- 1 Month Ago
Registered Nurse, Staff, Med/Surg
- Core Medical Group
-
Nashua, NH
FULL_TIME
- Experience Required: Position requires at least 1 year of relevant specialty experience. Shift: Eve/Night rotation CoreMedical Group is a nationally recognized leader in the medical recruitment and em...
- 26 Days Ago
Support Staff Fitness Specialist
- Corporate Fitness Works
-
Merrimack, NH
FULL_TIME
- Support Staff Fitness Specialist Imagine being a part of the CFW Solution, changing lives by serving the unique needs of the working population. Join us in engaging today's workforce through the deliv...
- 8 Days Ago
IT Specialist
- Sequel Medical Technology
-
Manchester, NH
FULL_TIME
- About SequelSequel Med Tech is an early-stage company developing the next generation of precision drug delivery devices.Job OverviewReporting to the Sr. Director, IT and Infrastructure, the Senior IT ...
- 19 Days Ago
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0 Medical Staff Credentialing Specialist jobs found in Nashua, NH area
Travel Physical Therapist - $1,860 per week
- Hiring Now!
-
Nashua, NH
- Care Team Solutions is seeking a travel Physical Therapist for a travel job in Nashua, New Hampshire. Job Description & ...
- 4/21/2024 12:00:00 AM
Travel Nurse RN - Med Surg / Telemetry - $2,501 per week
- Hiring Now!
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Nashua, NH
- Care Team Solutions is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Nashua, New Hampshire....
- 4/20/2024 12:00:00 AM
Travel Nurse RN - Labor/Delivery in Peterborough, NH
- Care Team Solutions
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Peterborough, NH
- Details: Must Have 2+ Years of recent Labor and Delivery experience. Specialty: Labor and Delivery Discipline: Registere...
- 4/20/2024 12:00:00 AM
Travel Nurse RN - Dialysis in Boston, MA
- Care Team Solutions
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Boston, MA
- Details: Must Have 2+ Years of recent Dialysis experience. Specialty: Dialysis Discipline: Registered Nurse Start Date: ...
- 4/20/2024 12:00:00 AM
Travel Nurse RN - Telemetry - $2,843 per week in Nashua, NH
- GO Healthcare Staffing
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Nashua, NH
- Our client in Nashua NH has a 12HR DAY (48HR) travel position for an RN with current Med/Tele experience. The ideal cand...
- 4/19/2024 12:00:00 AM
Travel Nurse RN - Telemetry - $2,683 per week in Concord, MA
- GO Healthcare Staffing
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Concord, MA
- Our client in Concord MA has a 8HR NIGHT travel position for an RN with current Med/Tele experience. The ideal candidate...
- 4/19/2024 12:00:00 AM
Travel Nurse RN - Telemetry in Salem, MA
- Care Team Solutions
-
Salem, MA
- Details: Must Have 2+ Years of recent Telemetry experience. Specialty: Telemetry Discipline: Registered Nurse Start Date...
- 4/19/2024 12:00:00 AM
Travel Nurse RN - Med/Surg - $2,445 per week in Gardner, MA
- GO Healthcare Staffing
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Gardner, MA
- Our client in Gardner MA has a 12HR NIGHT travel position for an RN with current MedSurg experience. The ideal candidate...
- 4/19/2024 12:00:00 AM
About Nashua, New Hampshire
Nashua is a city in Hillsborough County, New Hampshire, United States. As of the 2010 census, Nashua had a population of 86,494, making it the second-largest city in the state after Manchester. As of 2017 the population had risen to an estimated 88,341.
Built around the now-departed textile industry, in recent decades it has been swept up in southern New Hampshire's economic expansion as part of the Boston region. Nashua was twice named "Best Place to Live in America" in annual surveys by Money magazine. It is the only city to get the No. 1 ranking on two occasions—in 1987 and 1998.
Nashua is ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Specialist jobs
$48,351 to $60,821
Nashua, New Hampshire area prices
were up 1.4% from a year ago
were up 1.4% from a year ago
What does a Medical Staff Credentialing Specialist do?
Medical Staff Credentialing Specialist in Shreveport, LA
The University of Kentucky is committed to a diverse and inclusive workforce by ensuring all our students, faculty, and staff work in an environment of openness and acceptance.
December 08, 2019
This position will review credentialing/privileging information for accuracy and primary source verify all information in accordance all regulatory agencies and University of Kentucky policies and procedures.
December 06, 2019
Medical Staff Credentialing Specialist in Brownsville, TX
In addition, the Medical Staff Services Facility Specialist provides information and guidance regarding medical staff bylaws, medical staff ruled and regulations, allied health professionals (AHP) policies, Joint Commission for Accreditations of Healthcare Organizations (JCAHO) and Center for Medicare and Medicaid Services (CMS) and other regulatory agencies as they pertain to medical staff and allied health professionals.
December 05, 2019
Medical Staff Credentialing Specialist in Cincinnati, OH
Under minimal supervision coordinates, monitors and maintains the credentialing and re-credentialing process for the Medical Staff and Allied Health Professionals.
February 13, 2020