Credentialing Specialist

If you are confident you could do anything with the right guidance and opportunity, the Credentialing Specialist position with MPLT Healthcare is it! Below are our core values and are the positive attributes that will enable you to be successful:

  • Be The Best
  • Understand The Urgency
  • Never Ever Give Up
  • Have The Courage To Excel
  • Make A Contribution

THE POSITION:

MPLT Healthcare is seeking a full-time (8:30am-5:30pm) Credentialing Specialist. This position’s responsibilities will be the following:

This position’s responsibilities will be the following:

  • Reviewing and processing initial MPLT Healthcare Applications for locum tenens physicians
  • Re-credentialing existing MPLT Healthcare physicians
  • Primary source verification of physician backgrounds by calling hospitals, licensing boards, medical schools, etc.
  • Ensure timely and accurate submission of hospital privileging applications for each physician as it relates to each client.
  • Monitor and report on the credentialing progress of each physician.

CREDENTIALING:

  • Inspects provider applications and resumes for completion, consistency and accuracy. Quickly identify any discrepancies, gaps of employment and other challenges that could negatively impact our ability to credential a provider.
  • Runs queries, review NPDB reports, conducts compliance and sanctions monitoring. Notify recruiter and leaders of negative findings, immediately.
  • Mailing, faxing and emailing in order to obtain verifications, references and other pertinent data from appropriate sources in a timely manner.
  • Work closely with our physicians, the client’s Medical Staff Services department, and any 3rd Party groups in order to follow up on outstanding items needed to complete files in a timely manner to ensure that we meet applicable committee meeting dates and targeted start dates.
  • Conduct physician peer references over the phone verifying provider’s clinical competencies.
  • Utilize the CAQH database to enter and update physician data as needed for certain clients.
  • Respond in a timely manner to all requests from Physicians, Clients or their Medical Staff Services departments, and MPLT Healthcare’s recruiters.

LICENSING:

  • Initiate the state board licensing process by completing as much of the licensing application as possible.
  • Prepare detailed cover letters with step-by-step application instructions on how to complete and return the application, including steps to acquire supporting documents.
  • Expedite licensure application process by creating urgency via phone and email to collect relevant information in order to submit to the board and ultimately meet start date.
  • Coordinate submission of all verifications required by issuing state board by calling institutions listed in work and education history for accurate contact information in order to expedite on-time submittal of verification information.
  • Create urgency with institutions (hospitals, universities, medical boards, etc.) through follow-up calls and online resources to expedite verification completion and submission to the issuing state board.
  • Follow up with issuing state board to assess licensure status and expected completion date.

REQUIREMENTS:

  • 2 + years’ experience with medical credentialing processes. Locums experience is a plus.
  • Excellent interpersonal, written, verbal and presentation skills with the ability to communicate and discuss information in a professional and sensitive manner.
  • Strong organizational, critical thinking and problem-solving skills.
  • Detail-oriented with solid follow up skills.
  • Must be able to work in a fast paced environment and work well under pressure.
  • Microsoft Office skills and experience with a CRM/ATS database.
  • Comfortable with creating reports, analyzing data and making recommendations.
  • Self-motivated and has ability to work independently and make independent judgments and decisions within established guidelines.
  • Possess the knowledge, as well as the following skills and abilities or be able to perform the essential functions of the job, with or without reasonable accommodation, using some other combination of knowledge, skills, and abilities.
  • Ability to effectively interact with internal and external employees and other outside contacts.
  • Organize and prioritize workload while maintaining the ability to suddenly change what you are doing in order to meet necessary deadlines.
  • Demonstrable teamwork attitude.