RAYUS Radiology

RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible. We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services! RAYUS Radiology is an EO Employer/Vets/Disabled.

Medical Credentialing & Privileging Specialist

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteMid LevelTeam 1,571

Location

United States

Posted

6 days ago

Salary

Not specified

Seniority

Mid Level

Medical CredentialingMedical LicensingPrivilegingCAQHNPDBJCAHOCMSMicrosoft Office

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

RAYUS Radiology is looking for a Credentialing & Licensing Specialist to join our team. As a Credentialing & Licensing Specialist, you will be responsible for:

  • Physician state licensing initiatives
  • Facility privileging and internal appointments and reappointments
  • Conducting follow-up and timely responses to questions regarding pending applications
  • Coordinating and completing licensing and/or facility privilege requests in a timely manner
  • Maintaining electronic files for licensure and privileging
  • Ensuring the credentialing database is kept current

This is a 100% remote full-time position working 40 hours per week. Shifts are Monday-Friday.

Essential Duties and Responsibilities:

  • (55%) Provider Licensure
    • Compiles documents for state medical licensing boards for providers
    • Works closely with physicians throughout the licensing process
    • Tracks documents and timeframes associated with licensing and CME organization and knowledge of state licensing requirements related to CMEs
    • Processes State License renewals, DEAs, BLS, ALS, CDS and other certifications for state licensure
    • Coordinates with other departments as needed for licensure priority according to staffing needs
    • Researches state medical board requirements for physician providers as needed
    • Runs database reports, NPDBs, etc. as needed
    • Must meet all deadlines regarding provider licensure
  • (45%) Provider Privileging
    • Receives, evaluates and processes initial and reappointment applications including performing all applicable credentialing and recredentialing verification functions
    • Reviews the medical staff application for completeness and accuracy to initiate the verification process
    • Maintains accurate credentials for each provider (e.g., license status and expirations, board certifications, reappointments, and malpractice coverage)
    • Generates and analyzes reports from specialty database to monitor credentials of each provider
    • Communicates with providers and assigned departments to gather current credentials, as needed
    • Coordinates and monitors medical staff licensure applications/status changes and maintains Verity credentialing database
    • Communicates with internal and external colleagues and resources
    • Assists in organizing and development of monthly Credentials Committee Agenda
  • (5%) Other Duties and Projects as Assigned

Qualifications

  • High school diploma, or equivalent
  • Three (3) years’ experience with physician/provider licensure, privileging and credentialing
  • Familiarity with federal/state and regulatory and/or accrediting agencies
  • Previous customer service experience
  • Proficiency using Microsoft Office Suite applications
  • Proficiency using various computer systems and proficient typing skills

Requirements

  • Associate degree (preferred)
  • Working knowledge of CMS, CAQH, IMLCC, NPDB, and JCAHO (preferred)
  • Certified Provider Credentialing Specialist (CPCS) OR Certified Professional Medical Services Management (CPMSM) (preferred)

Benefits

  • Medical, dental and vision insurance
  • 401k with company match
  • Life and disability insurance
  • Tuition reimbursement
  • Adoption assistance
  • Pet insurance
  • PTO and holiday pay
  • Many more benefits (based on eligibility)

Company Description

RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible.

We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services! RAYUS Radiology is an EO Employer/Vets/Disabled.

Job Requirements

  • High school diploma, or equivalent
  • Three (3) years’ experience with physician/provider licensure, privileging and credentialing
  • Familiarity with federal/state and regulatory and/or accrediting agencies
  • Previous customer service experience
  • Proficiency using Microsoft Office Suite applications
  • Proficiency using various computer systems and proficient typing skills
  • Associate degree (preferred)
  • Working knowledge of CMS, CAQH, IMLCC, NPDB, and JCAHO (preferred)
  • Certified Provider Credentialing Specialist (CPCS) OR Certified Professional Medical Services Management (CPMSM) (preferred)

Benefits

  • Medical, dental and vision insurance
  • 401k with company match
  • Life and disability insurance
  • Tuition reimbursement
  • Adoption assistance
  • Pet insurance
  • PTO and holiday pay
  • Many more benefits (based on eligibility)

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