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Vighter Medical Group Credentialing Specialist in San Antonio, Texas

Credentialing Specialist

Job Details

Job Location

San Antonio, TX - San Antonio , TX

Position Type

Full Time

Education Level

Bachelor's Degree

Travel Percentage

Up to 25%

Job Category

Human Resources

Description

Position Description: The Credentialing Specialist is responsible for managing the credentialing process for healthcare providers, ensuring compliance with organizational policies, regulatory standards, and accreditation requirements. This role involves the collection, verification, and analysis of provider information to maintain accurate and up-to-date records.

Our Company Promise

We are committed to providing our Employees a stable work environment with equal opportunity for learning and personal growth. Vighter’s Mission is to provide efficient, fast, high quality healthcare staffing to our clients.

Our Culture’s key elements are crucial to the effectiveness of our employees in accomplishing our mission. The key elements include:

  • Dependability

  • Integrity

  • Personability

  • Transparency

  • Responsiveness

    Creating and cultivating this Culture within the organization is our commitment to our employees. Above all, Vighter employees will be provided the same concern, respect, and caring attitude that they are expected to share externally with every Vighter Client and Customer.

    Title: Credentialing Specialist

    Location: San Antonio, Texas

    Reports to: National Human Resources Manager

    Job summary:

    Vighter LLC is seeking a highly organized and detail-oriented Credentialing Specialist is responsible for managing the credentialing process for healthcare providers, ensuring compliance with organizational policies, regulatory standards, and accreditation requirements. This role involves the collection, verification, and analysis of provider information to maintain accurate and up-to-date records.

    Principle Accountabilities:

    Credentialing Process Management:

  • Facilitate initial credentialing and re-credentialing processes for healthcare providers.

  • Collect and verify all necessary documentation, including licenses, certifications, education, training, and work history.

  • Ensure timely completion and submission of credentialing applications.

    Verification and Documentation:

  • Conduct primary source verification of provider credentials.

  • Maintain detailed and organized records of all credentialing activities and documents.

  • Update provider information in the credentialing database and other relevant systems.

    Compliance and Quality Assurance:

  • Ensure credentialing processes comply with organizational policies, state and federal regulations, and accreditation standards (e.g., NCQA, Joint Commission).

  • Participate in internal and external audits related to credentialing.

    Communication and Coordination:

  • Liaise with healthcare providers, internal departments, and external agencies to resolve credentialing issues and ensure smooth workflow.

  • Communicate status updates and any required follow-up actions to providers and management.

    Continuous Improvement:

  • Identify opportunities to improve credentialing processes and implement best practices.

  • Stay informed about changes in regulatory requirements and industry standards.

    Requirements:

  • Bachelor’s degree in healthcare administration, business administration, or a related field preferred.

  • Minimum of 2-3 years of experience in credentialing, medical staff services, or healthcare administration.

  • Familiarity with credentialing software and database management.

  • Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred.

  • Attention to Detail: Exceptional accuracy in reviewing and verifying credentials.

  • Organizational Skills: Ability to manage multiple tasks and meet deadlines in a fast-paced environment.

  • Communication: Strong written and verbal communication skills for effective interaction with providers and staff.

    Physical Requirements :

  • Must be able to sit for more than 8 hours per day.

  • Must be willing to work overtime if necessary.

  • Must be able to use an elevator or walk up and down stairs.

  • Must be able to lift up to 10 lbs. and carry up to 10 ft.

  • Must be able to routinely grasp or handle objects, use finger dexterity, bend elbows/knees and reach above and below shoulders.

  • Must be able to read and interpret handwritten and typewritten print.

  • Must be able to communicate by voice and detect sound by ear.

  • Must be able to perform duties in an indoor or outdoor environment.

  • Must be able to pass a criminal background investigation.

  • Must undergo urine drug testing.

    Vighter LLC is an equal opportunity and affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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