Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Being a Medical Staff Credentialing Director maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Additionally, Medical Staff Credentialing Director analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
Credentialing Specialist
PMC Medical Group is a privately owned, multi-specialty medical group with locations throughout New Hampshire, providing care and compassion to patients for over 30 years, in the areas of pain management, family medicine and management of substance use disorders.
Job description:
The Credentialing Specialist will manage and monitor provider and facility credentials and maintain accurate data with insurance carriers to ensure a regulatory compliance and accurate payment from payers. The credentialing specialist will work closely with lead team members in Operations, HR and Accounting to ensure staff qualifications remain up to date and payer contracts remain competitive. Credentialing specialist will also work closely with the billing department to resolve any discrepancies with carrier payments.
The Ideal Candidate will have:
Salary dependent upon education and past experience.
As a team member at PMC Medical Group, you’ll enjoy:
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0 Medical Staff Credentialing Director jobs found in Portsmouth, NH area