What are the responsibilities and job description for the Provider Credentialing and Licensing Specialist - Central Business Office position at OrthoTennessee?
Description
Knoxville Orthopaedic Clinic is seeking a Provider Credentialing and Licensing Specialist for a full-time, hybrid (remote / in office) opportunity at our Central Business Office in West Knoxville. The Provider Credentialing and Licensing Specialist will be responsible for the onboarding of new providers, completing provider payer enrollment with all contracted plans and / or complete applications for provider privileges at hospitals / ASC. Additionally, the Provider Credentialing and Licensing Specialist will maintain provider data in credentialing software and payer sites to include; renewed documents, additions / deletions, demographics, practice updates, etc. Engage with payers and medical staff offices for required documentation. Additional administrative duties as assigned. Experience in credentialing or provider enrollment required. Strong computer and keyboarding skills with proficiency in Excel and Word. Excellent attention to detail is a must.
Key Responsibilities :
- Track and Monitor Medical Licenses :
Maintain a system for tracking the expiration and renewal dates of providers' medical licenses across relevant states and jurisdictions.
Track and monitor the status of DEA registrations for all providers.
Keep track of the expiration and renewal schedules of board certifications for providers.
Continuing Medical Education (CME) Management :
Track CME requirements for each provider based on their specialty, license, and board certification requirements.
Ensure the proper submission of all necessary documentation for medical licenses, DEA registrations, board certifications, and CME credits.
Proactively communicate with providers about upcoming renewals and requirements.
Stay updated on changes in medical licensing laws, DEA regulations, board certification requirements, and CME standards.
Work closely with the HR, legal, and medical leadership teams to ensure provider credentials are up to date and meet organizational standards.
Required Qualification and Skills :
High School diploma or equivalent.
2 years of experience in healthcare administration, compliance, or a similar role involving credentialing, licensing, and regulatory tracking.
Strong organizational skills with the ability to track multiple providers and their respective credentials.
Preferred Qualifications and Skills :
Bachelor's degree in healthcare administration, business, or a related field
Familiarity with state medical licensure processes, DEA registration requirements, board certification, and CME (Continuing Medical Education) regulations.
Certified Provider Credentialing Specialist (CPCS) or a similar credentialing certification.
At Knoxville Orthopaedic Clinic our purpose is to improve lives through patient-centered care; every patient, every time. And we've been doing just that since our practice was founded in 1930. As East Tennessee's largest orthopedic practice with 16 clinics and onsite therapy locations, 54 surgeons, over 1000 employees and have performed over 31K orthopedic procedures, we offer competitive pay and EXCELLENT benefits, such as low cost medical, dental, vision, 401K profit sharing, PTO, and employee discounts.
We are looking for people with a team-first mindset, who want to help others and are motivated by pursuing excellence. Our "Ideal Team Player" excels in building trust through active listening and collaboration, while being humble, hungry and people-smart. "It's not my job" is not a phrase you'll hear around here. We're team-driven, collaboration-minded and all-in, all the time. If this sounds like you, join our team!
Knoxville Orthopaedic Clinic was voted a TOP WORKPLACE for 2021 and 2022 by our employees!!
