Physician Credentialing

Please do not apply if you are not qualified, If you do not have physician credentialling experience please do not apply.

Position Overview:
The Agent Practitioner Credentialing in the Healthcare Setting is responsible for managing the credentialing and re-credentialing process for all healthcare practitioners within the surgical center. This role ensures that all practitioners meet the necessary standards and qualifications required to provide safe and effective care to patients. The Agent Practitioner works closely with administrative and clinical staff to maintain accurate and up-to-date credentialing records, ensuring compliance with regulatory and accreditation standards.

Key Responsibilities:
Credentialing and Re-Credentialing:
Manage the credentialing and re-credentialing process for all practitioners.
Verify practitioners’ credentials, including education, training, licensure, certifications, and work experience.
Ensure timely submission and processing of credentialing applications and documentation.

Compliance and Standards:
Ensure compliance with all regulatory and accreditation standards related to practitioner credentialing.
Maintain knowledge of current laws, regulations, and best practices in credentialing and healthcare.
Documentation and Records Management:

Maintain accurate and up-to-date credentialing files and databases.
Collect and verify all necessary documentation, including malpractice insurance, background checks, and peer references.
Prepare and present credentialing reports to relevant committees and boards.
Communication and Coordination:

Communicate with practitioners to obtain necessary information and documentation.
Coordinate with various departments, including Human Resources, Medical Staff Office, and Quality Assurance, to ensure seamless credentialing processes.
Respond to inquiries regarding credentialing status and requirements.

Quality Assurance:
Conduct regular audits of credentialing files to ensure accuracy and completeness.
Identify and address any discrepancies or issues in credentialing documentation.
Continuous Improvement:

Develop and implement process improvements to enhance the efficiency and effectiveness of the credentialing process.
Stay informed about industry trends and developments in credentialing and healthcare.
Qualifications:

Bachelor’s degree in Healthcare Administration, Business Administration, or a related field.
Minimum of 3 years of experience in healthcare credentialing, preferably in a surgical setting.
Strong knowledge of credentialing processes, regulatory requirements, and accreditation standards.
Excellent organizational and time management skills.
Strong attention to detail and accuracy.
Effective communication and interpersonal skills.
Proficiency in using credentialing software and databases.
Ability to work independently and as part of a team.

Preferred Qualifications:
Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification.
Experience with electronic health record (EHR) systems.
Familiarity with Joint Commission standards and other accreditation bodies.
Working Conditions:

Full-time position with standard working hours, although flexibility may be required during peak periods.

Reports to:
Credentialing Manager
This job description is intended to provide a general overview of the responsibilities and qualifications for the role of Agent Practitioner Credentialing in the Surgical Setting. It is not exhaustive and may be subject to change based on the needs of the Healthcare center.