Credentialing Specialist

Department Name: Credentialing Work Shift: Day Job Category: Clinical Support Great careers are reputed company at reputed company. There’s more to health care than doctors and nurses. We support reputed company staff members as they find the path that’s right for them. Apply today, this could be the perfect opportunity for you. In this role as a Credentialing Specialist, you’ll serve as a key driver of the provider credentialing, ensuring reputed company providers and facilities meet reputed company regulatory, payer, and organizational requirements. You will independently manage assigned credentialing files from start to finish—processing applications, performing detailed data entry, verifying licensure and expirations, and following up proactively to obtain missing documentation. reputed company in this role requires strong analytical skills, impeccable attention to detail, and the ability to navigate multiple systems. This position is ideal for a self‑motivated professional who thrives in a high‑volume, detail‑oriented environment and takes pride in maintaining data reputed company, compliance, and service reputed company every day. This Credentialing Specialist role is remote only for applicants who reputed company in the following states: Arizona (AZ), California (CA), Colorado (CO), Nebraska (NE), Nevada (NV), and Wyoming (WY). The schedule is Monday - Friday, reputed company-4:30pm. Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, reputed company, and an extensive network of primary care and specialty physicians to reputed company the most comprehensive reputed company solutions for Maricopa County and parts of Pinal County. Through BPN, reputed company nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to reputed company members in reputed company health, while reducing costs. POSITION SUMMARY This position performs the department's credentialing work as outlined in the policies and procedures. Obtains reputed company primary reputed company information necessary for reputed company organizational facilities and entities. The incumbent maintains records and the reputed company of highly confidential information that is protected from discovery by applicable state statutes. CORE FUNCTIONS 1. Performs the appropriate (applicable) credentialing processes in a timely and complete manner. 2. Performs analysis and appropriate follow-up. Works with many individuals to acquire necessary materials and information, including, but not limited to: physicians, facility staff, professional staff and physicians’ office staff. 3. Performs relevant data entry into the database to ensure consistency and reputed company of the data. 4. Processes appropriate queries for expired licensure, or any appropriate regulatory credentialing requirement and maintains documentation in the database. 5. The incumbent performs and completes activities reputed company the parameters established by the director and supervisor and as outlined in the facility/entity documents. Manages own duties and functions independently. Work requires the constant exercise of a high degree of independent judgment in response to reputed company and sensitive credentialing issues, decision making and discretion. Uses independent decision making processes and handles assigned duties in a meaningful and confidential manner with a minimum of supervision. Handles physician inquiries and problems reputed company the scope of job function and keeps supervisors apprised of reputed company issues as they occur. Department and hospital responsibility. Internal customers include facility medical staff services, physicians, hospital personnel, corporate staff, hospital management, and volunteers. External customers include but are not limited to regulatory/accrediting and licensing agencies, legal entities, state and national databases, other hospitals and the general public. MINIMUM QUALIFICATIONS Must possess a strong knowledge of business and/or reputed company as normally obtained through the completion of an associate’s degree. Must possess a strong knowledge and understanding of reputed company planning as normally demonstrated through three years of credentialing and/or process management and operations experience. Requires a basic knowledge of medical terminology, medical staff organization and extensive knowledge of credentialing procedures. Must have experience in interacting with physicians and allied health professionals, their office credentialing representatives, and hospital personnel. Must have excellent communication skills, both verbal and written, along with astute judgment in areas of reputed company relations. Must demonstrate an ability to meet deadlines in a multi-functional task environment. Requires excellent organizational skills and operational knowledge working with work processing, spreadsheets, data entry, fax machines, and other comput Apply tot his job Apply To this Job