NEVADA MEDICAL GROUP MANAGEMENT ASSOCIATION

Credentialing Specialist

11 Jan 2022 8:45 AM | Bria Mulder (Administrator)

Position Title: Credentialing Specialist
Location: Las Vegas NV
Contact Information: Holly Gavin, hgavin@pmclv.com

Position Description:

  • Responsible for all aspects of the credentialing, re-credentialing and privileging processes for medical providers. 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. 
ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:
  • Compiles and maintains current and accurate data for all providers
  • Completes provider credentialing and re-credentialing 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
  • Tracks license and certification expirations for all providers to ensure timely renewals
  • Ensures practice addresses are current with health plans, agencies and other entities
  • Audits health plan directories for current and accurate provider information
  • Maintains confidentiality of provider information
  • Provides credentialing and privileging verifications
  • Performs other duties as assigned
SKILLS:
  • Knowledge and understanding of the credentialing process
  • Ability to organize and prioritize work and manage multiple priorities
  • Excellent verbal and written communication skills including, letters, memos and emails
  • Excellent attention to detail
  • Ability to research and analyze data
  • Ability to work independently with minimal supervision
  • Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization
  • Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources
QUALIFICATIONS:
  • High school diploma or equivalent 
  • Two years of relevant credentialing experience in Nevada


Nevada MGMA
PO Box 3403, Hamilton, NJ 08619
866-492-3590