Credentialing Liaison Specialist

Overview:

The Credentialing Liaison Specialist plays a vital role in supporting the credentialing and re-credentialing processes for both W2 and 1099 healthcare providers. This position is instrumental in ensuring that all providers meet the organization’s compliance standards and regulatory requirements. Initial responsibilities will focus on documentation collection and verification, application processing, NPDB checks, and maintaining accurate provider records.

Key Responsibilities

1. Welcome Letters (W2):

• Review provider files for certificates, licenses, and immunizations
• Prepare and send welcome letters ensuring accuracy and a warm introduction
• Maintain an organized database of initial credentialing information

2. References:

• Send reference forms for all placed W2 and 1099 candidates, including Pine Ridge and Rosebud sites
• Collect, review, and verify references for completeness
• Follow up on outstanding references every 48 hours via phone
• Support re-credentialing processes by sending and tracking required reference forms

3. Application Processing:

• Prefill hospital applications for new hires and reappointments
• Ensure all required documents are completed accurately
• Maintain up-to-date provider files
• Coordinate with internal departments to address outstanding requirements
• Assist credentialing team members as needed

4. National Practitioner Data Bank (NPDB) Checks:

• Conduct NPDB checks for initial and re-credentialing candidates
• Document and report findings, discrepancies, or adverse actions

5. Case Logs:

• Request, collect, and review case logs from facilities
• Ensure compliance with hospital and regulatory standards
• Maintain accurate records and follow up on missing data

6. Hospital Verifications:

• Perform primary source verifications for credentials, privileges, and work history
• Track and document all verification activities

7. Documentation Management:

• Organize and securely store credentialing documents digitally
• Follow naming conventions to facilitate easy retrieval and audit readiness

8. Audit Preparation and Support:

• Prepare credentialing files for internal and external audits
• Resolve discrepancies and ensure files are complete and compliant

9. Empower Reappointment and Document Management:

• Provide support for reappointment cycles and ensure updated documentation is properly maintained

Skills and Competencies

• Attention to Detail:
  High accuracy in documentation, applications, and reference reviews
• Organizational Skills:
  Efficient multitasking and time management to meet deadlines
• Communication:
  Strong written and verbal skills for coordination and follow-ups
• Problem Solving:
  Proactive in resolving discrepancies and handling incomplete documentation
• Confidentiality and Integrity:
  Handles sensitive information with discretion and professionalism
• Adaptability:
  Ability to adjust to evolving processes in a fast-paced environment
• Team Collaboration:
  Works well with Credentialing Specialists and cross-functional teams
• Compliance Knowledge:
  Foundational understanding of healthcare regulations and standards
• Dependability:
  Consistent, reliable, and committed to quality and timely deliverables

This is a 100% Remote Work

Full time

Night shift

$5/hr