Southwest Diagnostic Imaging, Ltd. - Credentialing Specialist – Phoenix, AZ

Position Location: 2323 W. Rose Garden Lane, Phoenix, AZ 85027

Southwest Diagnostic Imaging, LTD., a leader in medical imaging, is currently seeking afull time Credentialing Specialist, responsible for performing and/or coordinating all activities associated with credentialing or re-credentialing practitioners. Perform all aspects of provider credentialing with contracted health plans and hospitals.

REQUIREMENTS:

  • High school diploma or General Education Degree (GED) required.
  • Experience with credentialing, claims billing, claims systems and claim issue research preferred.
  • Experience with provider and organizational/ancillary credentialing preferred.
  • Detail Oriented.
  • CPCS and/or CPMSM certification recommended.

ESSENTIAL DUTIES:

  • Complete all initial and re-credentialing of provider applications for assigned hospitals and health plans.
  • Initiates and coordinates the acquisition and receipt of all credentialing documentation from new and existing providers; provides follow-up and problem resolution as required.
  • Resolves credentialing issues with health plans and other organizations.
  • Maintains updated provider information, to include, but not limited to: Medical Licenses, DEA, BLS/ACLS/PALS, TB Clearance, and CME’s.
  • Update health plans with practice changes, including but not limited to, new site locations, equipment and provider activities.
  • Assist with initial and renewals of provider/group malpractice insurance.
  • Maintain provider data and update the shared files.
  • Maintain and ensure strict confidentiality of files and databases.
  • Facilitate and assist with internal and external records audits as appropriate.
  • Serves as Provider Liaison with Medical Staff Services departments.
  • Keep Manager informed of concerns, problems or issues with credentialing processes.
  • Other duties as deemed necessary.
  • Uphold all Southwest Diagnostic Imaging, Ltd. policies and procedures.

ESSENTIAL SKILLS REQUIRED:

  • Proficient in the use of personal computers, MS Office applications and related software.
  • Ability to multi-task and work in a fast paced environment.
  • Ability to work with minimal supervision.
  • Must be able to communicate calmly, compassionately, and professionally with providers, technical staff and other health care workers.
  • The ability to work effectively with other employees and maintain a cooperative working relationship intra-departmentally and inter-departmentally.
  • The demonstration of ethical and professional conduct, including the ability to maintain confidentiality (HIPAA).

ESSENTIAL PHYSICAL REQUIREMENTS AND WORK ENVIRONMENT:

  • While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms while operating the computer or phone equipment.
  • The employee must be able to remain in a stationary position while performing the essential duties of this position.
  • Specific vision abilities required by this job include close vision, color vision, ability to adjust focus.
  • Inside environment only with light background noise.
  • General air-conditioned environment.
  • Nonhazardous environment.

Qualified candidates should fax resume to 623-842-5640 or email to