LGS Practice Solutions is currently looking for qualified candidates for a Credentialing Specialist position. The Credentialing Specialist is responsible for all aspects of the credentialing, recredentialing, and privileging processes for all medical providers who provide patient care through Legacy Care. Ability to telecommute is possible.
An Equal Opportunity Employer/Veterans/Disabled. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status or on the basis of disability.
Responsibilities
The Credentialing Specialist is responsible for ensuring providers are credentialed, appointed and privileged with health plans, hospitals, and patient care facilities. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications. Responsibilities include:
- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and recredentialing applications; monitors applications and follows up as needed.
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Maintains corporate provider contract files.
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Sets up and maintains provider information in online credentialing databases and systems.
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies and other entities.
- Processes applications for appointment and reappointment of privileges to Legacy Care providers.
- Tracks license, DEA, and professional liability expirations for appointed Legacy Care providers.
- Maintains Legacy Care appointment files, and information in credentialing database.
- Audits health plan directories for current and accurate provider information.
- Maintains confidentiality of provider information.
- Provides credentialing and privileging verifications.
Knowledge, Skills, and Abilities
To perform this job successfully, an individual must be able to perform each responsibility satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Knowledge and understanding of the credentialing process.
- Ability to organize and prioritize work and manage multiple priorities.
- Ability to work independently with minimal supervision.
- Proficient use of Microsoft Office applications and internet resources.
- Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
Required Qualifications
- Associates degree
- Certified Provider Credentialing Specialist
- Two years of relevant credentialing experience
Preferred Requirements
Candidates with these desired skills will be given preferential consideration:
LGS Practice Solutions is a Revenue Cycle Management company under LGS Management Group. With corporate offices in Virginia Beach, VA, Practice Solutions is a fast-growing company providing billing, credentialing, practice and revenue management services.
Benefits
- Comprehensive medical, dental and vision insurance
- 401K
- Basic and voluntary life insurance
- Disability coverage
- Paid time off
