Medical Credentialing & Privileging Specialist

RAYUS Radiology•Pittsburgh, PA

6d•Remote

About The Position

RAYUS Radiology is looking for a Credentialing & Licensing Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Credentialing & Licensing Specialist, you will be responsible for physician state licensing initiatives, facility privileging and internal appointments and reappointments, including conducting follow-up and timely responses to questions regarding pending applications. This role coordinates and completes licensing and/or facility privilege requests in a timely manner, maintains electronic files (for licensure and privileging) and ensures the credentialing database is kept current. This is a 100% remote full-time position working 40 hours per week. Shifts are Monday-Friday.

Requirements

High school diploma, or equivalent
Three (3) years’ experience with physician/provider licensure, privileging and credentialing
Familiarity with federal/state and regulatory and/or accrediting agencies
Previous customer service experience
Proficiency using Microsoft Office Suite applications
Proficiency using various computer systems and proficient typing skills

Nice To Haves

Associate degree
Working knowledge of CMS, CAQH, IMLCC, NPDB, and JCAHO
Certified Provider Credentialing Specialist (CPCS) OR Certified Professional Medical Services Management (CPMSM)

Responsibilities

Compiles documents for state medical licensing boards for providers.
Works closely with physicians throughout the licensing process.
Track documents and timeframes associated with licensing and CME organization and knowledge of state licensing requirements related to CMEs.
Process State License renewals, DEAs, BLS, ALS, CDS and other certifications for state licensure.
Coordinates with other departments as needed for licensure priority according to staffing needs
Research state medical board requirements for physician providers as needed.
Runs database reports, NPDBs, etc. as needed.
Must meet all deadlines regarding provider licensure
Receives, evaluates and processes initial and reappointment applications including performing all applicable credentialing and recredentialing verification functions
Reviews the medical staff application for completeness and accuracy to initiate the verification process
Maintains accurate credentials for each provider (e.g., license status and expirations, board certifications, reappointments, and malpractice coverage)
Generates and analyzes reports from specialty database to monitor credentials of each provider
Communicates with providers and assigned departments to gather current credentials, as needed
Coordinates and monitors medical staff licensure applications/status changes and maintains Verity credentialing database
Communicates with internal and external colleagues and resources
Assists in organizing and development of monthly Credentials Committee Agenda Performs
Other Duties and Projects as Assigned