JOB TITLE: Credentialing Specialist
EMPLOYMENT DURATION: Full time
FLSA STATUS: Non-exempt
JOB OVERVIEW: Responsible for all aspects of the credentialing, recredentialing and
privileging processes for all medical providers and mid-levels at Washington Center for Pain Mgmt. and Bellevue Surgery Center. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.
1. Make sure all providers are in network with current insurance companies
2. Compiles and maintains current and accurate data for all providers in the system.
3. Completes provider credentialing and recredentialing applications; monitors applications
and follows-up as needed.
4. Maintains copies of current state licenses, DEA certificates, malpractice coverage and
any other required credentialing documents for all providers.
5. Maintains knowledge of current health plan and agency requirements for credentialing
6. Tracks license and certification expirations for all providers to ensure timely renewals.
7. Relay information to management, billing department, and scheduling dept.
1. Knowledge and understanding of the credentialing process.
2. Ability to organize and prioritize work and manage multiple priorities.
3. Excellent verbal and written communication skills including, letters, memos and emails.
4. Excellent attention to detail.
5. Ability to research and analyze data.
6. Ability to work independently with minimal supervision.
7. Ability to establish and maintain effective working relationships with providers,
management, staff, and contacts outside the organization.
8. Proficient use of Microsoft Office applications (Word, Excel, Access) and internet
BA with at least 2 years of provider enrollment experience or credentialing/privileging processes
OR AA with at least 3 year of experiences.
Licenses/Certificates/Registration: None. Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred.
The Washington Center for Pain Management acknowledges a multidisciplinary approach is the most effective way to minimize pain and restore functionality. Our individualized pain management strategy includes the physical, psychological and emotional aspects of chronic pain, and empowers each patient to take back control of their lives.