What are the responsibilities and job description for the Credentialing Specialist position at NorthStar Anesthesia?
Role Overview
Summary/Objective: The credentialing specialist will provide customer service centered and timely credentialing, re-credentialing and other necessary credentialing and provider enrollment activities for onboarding of initial and continued privileges of NorthStar Anesthesia medical providers caring for our patients. Such activities shall be performed in accordance with organization and department policies and procedures.
Essential Functions:
1. Perform credentialing activities within the organizational and department policies and procedures as well as applicable federal, state and accreditation regulatory standards.
2. Maintain knowledge of current provider enrollment requirements and client medical facility requirements for credentialing of providers.
3. Initiate credentialing and re-credentialing applications on behalf of providers for submission to client medical facilities as well as to applicable medical billing agencies.
4. Review provider files, document and report as applicable to recruiting, operations and client medical facility representatives of known malpractice claims, NPDB report activity, license disciplinary action or other activity that may affect medical provider credentialing.
5. Monitor, collect and maintain current copies of medical licenses, DEA certificates, malpractice coverage and other required credentialing documents for all providers.
6. Routinely monitor application processing and follow up as required until completion and provider is granted privileges at client medical facilities and applicable documentation is submitted to medical billing agencies.
7. Report to credentialing manager status of departmental operations and provider credentialing issues of concern.
8. Document and maintain credentialing activities of medical providers through utilization of department software application system and individual provider files.
9. Send notifications to client medical facilities and medical billing agencies regarding provider changes, including name changes, privilege resignations and terminations.
10. Establish and maintain customer service centered and productive working relationships with medical providers, peers, department partner teams, management staff and contacts outside the organization.
11. This role can be designated as hybrid or remote.
- Hybrid: This position will require at least 2 days per week at assigned work site along with in-person organizational meetings; all other days may be worked remotely.
- Remote: This position works remotely; work site attendance may be required from time to time in accordance with business conditions.
12. Promote NorthStar Anesthesia’s Core Values.
13. Demonstrates regular, reliable and predictable attendance.14. Performs other duties as required.
Qualifications:
- High school diploma or equivalent; associates degree or equivalent preferred. CPCS certification a plus.
- Minimum of three years of work-related experience in the field of medical provider credentialing for medical facility fulfillment.
Knowledge, Skills and Abilities:
- Proficient in Office 365 and applications (Word, Excel, Teams, Outlook)
- Customer service / client focus communication (verbal and written)
- Experience with primary sourcing of provider licensure, board certification, NPI, NPDB.
- Experience in using a provider credentialing software or provider data management system
- Attention to detail and documentation
- Work well in a team environment.
- Ability to organize and prioritize work and manage multiple priorities.
- Professional verbal and written communication skills
About The Facility
Fuel your career with excitement at NorthStar Anesthesia! We’re looking for a proactive, detail-driven Credentialing Specialist to join our high-energy team. In this role, you’ll ensure top-tier provider credentials, directly impacting the quality of care in hospitals across the nation. If you're ready to dive into a fast-paced environment where your expertise keeps healthcare moving, apply now and be part of something extraordinary!
Qualifications
Why Join Us?
At NorthStar Anesthesia, we offer competitive benefits and a supportive environment where your career can thrive. We provide 4-5 weeks of paid time off, 11 paid holidays, annual HSA contributions, a 401(k) match, and more. Join a team that values your expertise and is committed to your growth!
We are committed to Diversity, Equity, and Inclusion. We understand that women and others from underrepresented minority groups may hesitate to apply unless they meet every qualification. We encourage you to apply, even if you don't meet all the criteria - your unique perspectives and experiences are valued here.
NorthStar is an Equal Opportunity Employer. We do not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status, or any other basis covered by appropriate law. We are committed to having a workforce that celebrates diversity, equity, and inclusion. We are an Affirmative Action Employer.
