Credentialing Specialist

Exceed Healthcare is a premier management services organization (MSO) that provides an extensive range of first-class administrative solutions to healthcare providers, enabling them to focus on delivering exceptional patient care and optimizing clinical outcomes. Over the past 10+ years, we have grown to be one of the fastest growing management services organizations in our industry.

Summary: Responsible for all aspects of the credentialing, re credentialing, and privileging processes for all medical providers who provide patient care as clients of Exceed Healthcare. 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.

Job Duties

As a Credentialing Specialist for Exceed Healthcare LLC, Your job duties include, but are not limited to, the following:

Hospital/Provider Credentialing

• Compiles and maintains current and accurate data for all providers.
• Complete 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.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.
• Set up and maintain provider information in online credentialing databases and systems.
• Tracks license and certificate expirations for all providers to ensure timely renewals.
• Ensures practice addresses are current with health plans, agencies and other entities.
• Processes applications for appointment and reappointment of privileges for providers who are clients of Exceed Healthcare.
• Tracks license, DEA, and professional liability expirations for appointed Exceed Healthcare providers.
• Maintains Exceed Healthcare client appointment files, and information in credentialing database.
• Set up and maintain provider information via CAQH.
• Accessing PHI/EPHI. Credentialing Coordinators will only access this in direct relation to patient care.
• Manage the completion and submission of initial provider malpractice insurance applications.
  
  

Additional Responsibilities

• Maintain confidentiality of provider information
• Provides credentialing and privileging verifications
• Performs other duties and special projects as assigned.
  
  

Exceed Offers

• PTO Package for all non-clinical full time employees.
• Training
• Health, Dental, Vision benefits
• 401K
• Growth Opportunities
  
  

We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.