Medical Staff Credentialing Specialist jobs in Bloomington, IL

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 sets up and maintains provider information in an online credentialing database system. Tracks license and certification expirations for all providers to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist may require an associate degree or equivalent. May require certification as a Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor or manager. 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)

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Credentialing Specialist
  • Fast Pace Health
  • Tennessee, IL OTHER
  • Posting Title

    Credentialing Specialist

    Overview

    In a way, that best supports our values, the individual is responsible for the daily activities of credentialing and payor enrollment processes for Fast Pace. The Credentialing Specialist will play an important role in leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process. The Credentialing Specialist facilitates all aspects of Fast Pace’s credentialing, including initial provider enrollments, reassignments, and maintenance updates, as well as the credentialing of providers for health plan clients. The Credentialing Specialist ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing and payor enrollment.

    Responsibilities

    Essential Functions:

    • Obtains, verifies, and analyzes all required information pertinent to internal and external Credentialing.
    • Organizes the credentialing process to meet required timelines.
    • Educates and supports clinicians in completing the credentialing process.
    • Interfaces with health plan contacts to understand and support the credentialing application and completion process.
    • Supports company processes to assure licensure and certification are maintained.
    • Supports company processes for state regulatory requirements for physicians, nurse practitioners, physician assistants and other providers.
    • Participates with the team to implement and adhere to policies, procedures, and systems to ensure timely data entry and enrollments in current Practice Management system.
    • Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
    • Collaborates with Manager of Credentialing to create new processes and procedures as needed to improve overall claims escalation process.
    • Performs a variety of administrative duties including, but not limited to: answering phones, faxing and filing
    • Responsible for learning the aspects of compliance in the company by completing all mandatory compliance training.
    • The ability to maintain friendly, cordial relations with fellow coworkers.
    • The ability to build and maintain confidence and credibility with fellow coworkers.
    • The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers.
    • The ability to perform the physical, use of senses, cognitive, and environmental functions of the position, as specified on the physical demands.
    • Ability to comply with Company standards of operations.
    • Ability to adhere to the Core Values of the Company, of teamwork, communication, empowerment, quality of care, and friendliness.
    • The ability to promote and maintain a respectful culture of employee, employer and business confidentiality.
    • Perform other duties as assigned by management.

    Experience Requirements and Preferences:

    Basic Requirements: 

                Education:                 High School Diploma or its equivalent

                    AND

    Experience:   Previous experience in credentialing of physicians, nurse practitioners, or physician

    assistants (minimum of 2 years preferred)

    • Associate’s or Bachelor’s Degree in healthcare or business administration (preferred but not required)
    • Experience in use of the Council for Affordable Quality Healthcare (CAQH), Universal Provider Data source (UPD) for credentialing support.
    • Ability to use computer systems including but not limited to Word, Excel, and

    credentialing software

    • Excellent organizational skills
    • Strong customer service approach
    • Attention to detail
    • Ability to work independently

    Current License or Certification:

    • Not required at time of hire, but Fast Pace will assist with CPCS or CPMSM certification.

    Education Requirements:

    High School Diploma or Its Equivalent

    Compliance

    Fast Pace Health is committed to the principle of equal employment and creating an inclusive environment for the benefit of our employees, our patients, and our communities. We are an equal opportunity employer and welcome job applications from qualified individuals without regard to race, creed, color, ancestry, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, disability, veteran status, marital status, parental status, genetic information or any other legally protected characteristics or conduct. Please refer to the links below for information regarding your rights under certain federal laws: https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/fmlaen.pdfhttps://www.dol.gov/whd/regs/compliance/posters/eppac.pdfMississippi Residents Only:In Mississippi, Fast Pace requires pre-employment/drug/alcohol testing as a condition of employment. The law requires that Fast Pace notify applicants, in writing, upon application and prior to the collection of the specimen for drug and alcohol test, that they may be tested for “the presence of drugs [or alcohol] in their metabolites.” Miss. Code. Ann. § 71-7-3(5).

    Brand Name

    FastPace Health
  • 2 Months Ago

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Travel MA - Medical Assistant
  • Focus Staff Services
  • Peoria, IL OTHER
  • OverviewWe currently have a client in Peoria, IL looking for Medical Assistant!Focus Staff is seeking a Medical Assistant who is highly motivated and energetic.Contract Assignment – 13 Weeks (Temporar...
  • 1 Month Ago

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Travel Medical Assistant - $1155.62 / Week
  • TLC Travel Staff
  • Peoria, IL FULL_TIME
  • TLC Travel Staff is seeking an experienced Medical Assistant for an exciting Travel Allied job in Peoria, IL. Shift : 5x8 hr flex Start Date : ASAP Duration : 13 weeks Pay : $1155.62 / Week Job Descri...
  • 18 Days Ago

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Travel ASCP/AMT - Travel Med Tech - Medical Technologist
  • Focus Staff Services
  • Peoria, IL OTHER
  • OverviewWe currently have a client in Peoria, IL looking for a Medical Technologist (Traveling Medical Technologist)Focus Staff is seeking a traveling Certified Medical Technologist, who is responsibl...
  • 23 Days Ago

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Medical Records Staff
  • NORTH CENTRAL BEHAVIORAL HEALTH SYSTEM
  • La Salle, IL FULL_TIME
  • Full-Time 32 hours per week Job Summary: Under the supervision of the Manager of Support Services, maintains clinical record integrity and confidentiality, while completing tasks and duties related to...
  • 8 Days Ago

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Staff Development Specialist
  • MOSAIC
  • Macomb, IL FULL_TIME
  • If making a positive impact in the lives of others is always on your to-do list — you’ll LOVE working with a team that puts people first. We're looking for a Sr. Staff Development Specialist to join o...
  • 3 Days Ago

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0 Medical Staff Credentialing Specialist jobs found in Bloomington, IL area

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Travel Nurse RN - Acute Care - $2,197 per week
  • TRS Healthcare
  • Peoria, IL
  • Care Team Solutions is seeking a travel nurse RN Acute Care for a travel nursing job in Peoria, Illinois. Job Descriptio...
  • 3/28/2024 12:00:00 AM

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Travel Nurse RN - Med Surg - $2,093 per week
  • TRS Healthcare
  • Peoria, IL
  • Care Team Solutions is seeking a travel nurse RN Med Surg for a travel nursing job in Peoria, Illinois. Job Description ...
  • 3/28/2024 12:00:00 AM

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Travel Nurse RN - Oncology - $2,209 per week
  • TRS Healthcare
  • Peoria, IL
  • Care Team Solutions is seeking a travel nurse RN Oncology for a travel nursing job in Peoria, Illinois. Job Description ...
  • 3/28/2024 12:00:00 AM

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Travel Nurse RN - Rehabilitation - $2,325 per week
  • TRS Healthcare
  • Peoria, IL
  • Care Team Solutions is seeking a travel nurse RN Rehabilitation for a travel nursing job in Peoria, Illinois. Job Descri...
  • 3/28/2024 12:00:00 AM

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Child Care Teacher - Bloomington
  • Bright Horizons Family Solutons
  • Bloomington, IL
  • Child Care Teacher - Bright Horizons at Bloomington 2432 Malloney Dr. Bloomington, IL, 61704 Imagine your future as a te...
  • 3/28/2024 12:00:00 AM

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Child Care Teacher - Bloomington
  • Bright Horizons
  • Bloomington, IL
  • **Child Care Teacher - Bright Horizons at Bloomington** 2432 Malloney Dr. Bloomington, IL, 61704 Imagine your future as ...
  • 3/28/2024 12:00:00 AM

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Travel Nurse RN - PACU - Post Anesthesia Care - $2,325 per week
  • TRS Healthcare
  • Peoria, IL
  • Care Team Solutions is seeking a travel nurse RN PACU - Post Anesthesia Care for a travel nursing job in Peoria, Illinoi...
  • 3/27/2024 12:00:00 AM

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Travel Nurse RN - Manager - $1,860 per week
  • TRS Healthcare
  • Peoria, IL
  • Care Team Solutions is seeking a travel nurse RN Manager for a travel nursing job in Peoria, Illinois. Job Description &...
  • 3/24/2024 12:00:00 AM

Bloomington is a city in and the county seat of McLean County, Illinois, United States. It is adjacent to Normal, and is the more populous of the two principal municipalities of the Bloomington-Normal metropolitan area. The 2010 Census showed the city had a population of 76,610, making it the 12th most populated city in Illinois, and the fifth-most populous city in the state outside the Chicago Metropolitan Area. Combined with Normal, the twin cities have a population of roughly 130,000. Bloomington is located at 40°29′03″N 88°59′37″W. The city is at an elevation of 797 feet (243 m) above sea ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Specialist jobs
$39,283 to $49,745
Bloomington, Illinois area prices
were up 1.3% from a year ago

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