Demo

Physician Credentialing Specialist

Velocity Made Good (VMG)
Nashville, TN Full Time
POSTED ON 2/6/2025
AVAILABLE BEFORE 4/5/2025
Job Description

Physician Credentialing Specialist

Comprehensive Healthcare Provider Coordinator

Position Details

  • Location: Fully remote
  • Hours – 40 hours per week, remote with flexible scheduling
  • Availability – Must be available for meetings in Mountain and Central Time and to contact appropriate parties during business hours. Other tasks can be completed on a flexible schedule
  • Rate – $25 - $26 per hour - salary based on years of experience, education, and certification status
  • Start Date – Immediate
  • Clients – Supporting two clients—one in Mountain Time and one in Central Time (20 hours per week per client)

Job Summary

  • Manage Credentialing & Enrollment
    • Oversee credentialing, recredentialing, and provider enrollment to ensure compliance with federal, state, and accreditation standards
  • Verify & Maintain Provider Credentials
    • Confirm education, licensure, certifications, malpractice history, and disciplinary actions to ensure eligibility
  • Ensure Compliance with Regulations
    • Stay up to date on Medicare (CMS), Medicaid, and commercial payer requirements to prevent delays or compliance issues
  • Handle Provider Enrollment & Contracting
    • Manage applications and contracts with payers, ensuring timely approvals and adherence to policies
  • Maintain & Update Credentialing Records
    • Track expiration dates for licenses, DEA registration, and board certifications to prevent lapses
  • Communicate with Key Stakeholders
    • Work directly with physicians, payers, and regulatory agencies to resolve credentialing issues
  • Conduct Compliance Audits
    • Perform periodic reviews of credentialing files to ensure adherence to legal and accreditation standards
  • Support Provider Onboarding
    • Assist with enrollment and ensure all necessary approvals before providers begin seeing patients
Qualifications

  • Experience in Medical Credentialing
    • Minimum of five (5) years in credentialing, provider enrollment, or healthcare administration
  • Expertise in CMS, Medicaid & Commercial Payers
    • Strong knowledge of payer-specific requirements and regulations
  • Understanding of Legal & Accreditation Standards
    • Familiarity with NCQA, Joint Commission, and CMS compliance guidelines
  • Strong Organizational & Technical Skills
    • Ability to manage multiple deadlines with attention to detail
    • Proficiency in credentialing software, payer portals, and Microsoft Office Suite
  • Excellent Communication & Problem-Solving
    • Ability to collaborate across departments and resolve credentialing issues efficiently
  • Certification (Preferred, Not Required)
    • CPCS or CPMSM certification is a plus
Company Description

VMG s a network of revenue cycle professionals, the majority of whom are at a Senior & Executive Level. Our healthcare professionals, with an average of 20 years’ experience in the industry, understand the unique nuances and requirements of healthcare organizations. VMG’s “hands-on” professionals expand leadership teams to help direct strategic initiatives, manage system design and build, and implementation efforts. We assess situations, chart a strategy and lead the achievement of results. Because we are “operators”, we know what it takes to execute and achieve results. VMG healthcare experts have supported client initiatives across the country.

Our core competencies include building interpersonal relationships, communication, strong finance and business acumen, clinical knowledge, collaboration and team building, changes in management, and quality improvement. VMG’s reputation for promoting the vision of the organization, listening and responding to barriers of achievement, providing job training to instil

VMG s a network of revenue cycle professionals, the majority of whom are at a Senior & Executive Level. Our healthcare professionals, with an average of 20 years’ experience in the industry, understand the unique nuances and requirements of healthcare organizations. VMG’s “hands-on” professionals expand leadership teams to help direct strategic initiatives, manage system design and build, and implementation efforts. We assess situations, chart a strategy and lead the achievement of results. Because we are “operators”, we know what it takes to execute and achieve results. VMG healthcare experts have supported client initiatives across the country. Our core competencies include building interpersonal relationships, communication, strong finance and business acumen, clinical knowledge, collaboration and team building, changes in management, and quality improvement. VMG’s reputation for promoting the vision of the organization, listening and responding to barriers of achievement, providing job training to instil

Salary : $25 - $26

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