Medical Credential Specialist

Company: IntelliCentrics
Location: Flower Mound
Posted on: June 14, 2022

Job Description:

IntelliCentrics is a technology company focused on transforming how regulatory compliance is achieved in the healthcare industry. IntelliCentrics is a market leader because of its obsessive focus on our customers and the relationships built with those customers are our most important achievement and measurement of success. IntelliCentrics will use its technology to deliver on its mission, our mission is to make high quality healthcare as accessible as a good cup of coffee.
We are searching for a Medical Credential Specialist that will be responsible for the administration of inbound Medical Staff Office (MSO) credential verification related to IntelliCentrics Service Offering.
Work done in the Office in Flower Mound, TX
Responsibilities

• Facilitate medical staff credentialing process, including:
• Process required credentials of assigned health care providers
• Review applications, prepare verification letters and process verification responses
• Conduct primary source verification with appropriate agencies and organizations, per verification process, policies, and compliance
• Communicate with location of care staff and health care provider to obtain additional information and clarifications as needed
• Answer questions and responds to inquiries concerning applications being processed, from location of care staff and health care provider being credentialed
• Maintain compliance of all credentialing processes and policies including:
• Process verifications
• Incorporate changes that may occur due to regulatory standards as they occur
• Apply process uniformly
• Maintain the integrity of data, the security of documents, and confidentiality of information
• Follow established standards to ensure applications are completed within established SLA's
• Coordinate with internal Credentialing Quality Specialist to execute team training on MSO policy and compliance changes
• Maintain knowledge of Sec3ure Standard and Process Guide for accurate and compliant credential verification
• Support all NCQA responsibilities, including audit preparation and documentation updates
• Suggest improvements to processes and/or revisions and updates to shared database and step-by-step instruction tool
• Participate as needed in testing/validation involving new products or bug fixes during Sprint Deployment
• Special projects as assigned
  Required Education & Experience
  • High school diploma or general education degree (GED) required; Bachelor's Degree preferred
  • Minimum 2 years Healthcare Administration and customer service experience required
  • 2 or more years of experience in a medical staff credentialing function desirable
  • 2+ year(s) demonstrated success in a high volume, high growth environment
  • CPCS Certification preferred
    IntelliCentrics is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Keywords: IntelliCentrics, Flower Mound , Medical Credential Specialist, Healthcare , Flower Mound, Texas