Medical Credentialing Specialist

About us

Rankin Rural Medical Clinic is patient-centric, engaging, and collaborative. We work to provide convenient, quality, affordable healthcare to families in Rankin County.

Duties and Responsibilities

•Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, and local regulations, guidelines, policies, and standards.

•Conducts primary source verification, collects and validates documents to ensure accuracy of all credentialing elements; assesses completeness of information and qualifications relative to credentialing standards.

•Identifies, analyzes, and resolves extraordinary information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners

Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies.

Enters, updates, and maintains data from provider applications into the credentialing database.

Prepares, issues, electronically tracks, and follows up on appropriate verifications.

Communicates clearly with providers and their liaisons.

Maintains professional growth and development through seminars, workshops, and professional affiliations to enhance understanding of various regulations and legislation of the rural healthcare industry.

Performs miscellaneous job-related duties as assigned.

Minimum Job Requirements

• High school diploma or GED; at least 5 years of experience directly related to the duties and responsibilities specified.
• Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.

Knowledge, Skills and Abilities Required

• Ability to communicate effectively both orally and in writing.
• Customer service skills.
• Ability to respond to emails timely and effectively.
• Information research skills.
• Knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures, and documentation.
• Working knowledge of clinical and/or hospital operations and procedures.
• Ability to use independent judgment and to manage and impart confidential information.
• Ability to maintain confidentiality and discretion in all communications on behalf of credentialing applicants and/or applications.
• Ability to make administrative/procedural decisions and judgments.
• Demonstrated advanced working knowledge of Microsoft Word and Excel.
• Ability to learn new applications to function effectively in a remote work environment.
• Skill in establishing priorities with independent coordination of day-to-day aspects.
• Advanced skills in computerized spreadsheeting and database management.

Job Type: Contract

Pay: $17.00 - $19.15 per hour

Benefits:

• Flexible schedule

Schedule:

• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• Medical credentialing: 5 years (Required)

Work Location: Hybrid remote in Richland, MS 39218