Medical Credentialing Specialist

Pulse Staffing has an exciting career opportunity for a Medical Credentialing Specialist. Pulse Staffing is the premium provider of the highest quality health care professionals to many of the Houston’s top rated hospitals and healthcare networks.

We are looking for a hardworking, energetic, compassionate and experienced Medical Credentialing Specialist to work in a clinic setting located in Northwest Houston. This position is for a radiology clinic.

Job Description:

1.       Compiles and maintains current and accurate data for all providers

2.       Completes provider credentialing and re-credentialing application; monitors applications and follows-up as needed

3.       Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers

4.       Maintains corporate provider contract files

5.       Maintains knowledge of current health plan and agency requirements for credentialing providers

6.       Sets up and maintains providers information in online credentialing databases and system

7.       Tracks license and certification expirations for all providers to ensure timely renewals

8.       Ensures practice addresses are current with health plans, agencies and other entities

9.       Tracks license, DEA and professional liability expirations for appointed providers

10.   Audits health plan directories for current and accurate provider information

11.   Create and maintain radiologists credentialing files

12.   Research and obtain verification of radiologist credentials

13.   Coordinate with hospital / center and radiologists to complete credentialing process, including any additional documentation, verifications, references, and applications necessary

14.   Complete and review all applications to ensure accuracy prior to submission

15.   Facilitate provider re-attestations of CAQH data as required by CAQH

Qualifications:

1.       1-2 years of relevant credentialing experience

2.       High School Diploma or equivalent

3.       Associates degree preferred

4.       Ability to organize and prioritize work and manage multiple priorities

5.       Excellent verbal and written communication skills including letters, memos and emails

6.       Ability to research and analyze data

7.       Ability to work independently with minimal supervision

8.       Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside of the organization

9.       Proficient use of Microsoft Office applications (Word, Excel. Access) and internet resources

Job: Credentialing Specialist, Healthcare

Location: Northwest Houston