Job Description

HOURS: 40 hours/week, Dayshift

JOB TYPE:  Contractor (1099)

REPORTS TO:   Manager, Medical Staff , Avel  eCare  

SUMMARY:

The Licensing and Credentialing Specialist is responsible for gathering and maintaining information needed for licensing, credentialing, and re-credentialing of all Avel eCare providers, distributing information to the appropriate sites/agencies, preparing summaries and reports as requested, and maintaining the provider database and highly confidential personnel files.

ESSENTIAL FUNCTIONS:   

1. Responsible to work independently in obtaining and supporting licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging processes of all Avel eCare practitioners, including but not limited to physicians (MD and DO) and non-physician practitioners (CNP and PA), registered nurses, respiratory therapists, social workers, and pharmacists. Reprioritizes work as necessary to meet deadlines. 

2. Maintains a working knowledge of and independently ensures compliance with applicable policies and procedures, The Joint Commission standards, Centers for Medicare and Medicaid Services (CMS) standards, and applicable federal and state laws; and applies them to the licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging process.

3. Maintains a comprehensive electronic and hard copy filing system. Collects and distributes appropriate information regarding each Avel eCare clinical nurse and medical practitioner (with practitioners’ assistance, as appropriate) in an accurate and timely manner without deficiency and in a cost-effective manner. Ensures the accuracy and integrity of electronic tools used for tracking and follow up regarding the licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging processes. Generates Avel eCare practitioner specific reporting including, but not limited to state licensure and hospital affiliation.

4. Establishes and maintains effective working relationships with practitioners, practitioner affiliated clinic managers, Avel eCare customers, state licensure representatives, various Medical Support Services offices, Credentialing and Verification Service, other departments, and other applicable resources. Ensures good communication with all entities to maintain accurate information and alerts upper management of potential issues affecting stakeholder relationships.

5. Provides status information to appropriate stakeholders of nursing or medical licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging processes in a timely and professional manner.

6. Performs generalized secretarial duties in an accurate and timely manner to include, but not limited to transposes handwritten or verbal communication to a typed format, edits all typing for typos and corrects as necessary, makes copies of products as requested, collates, assembles, and distributes information as directed. Processes mail, faxes, and other types of communications.

7. Maintains competencies in using software programs including credentialing platforms Internet Explorer, Microsoft Outlook and Microsoft Office Products, and Adobe Acrobat, etc. 

8. Organizes and executes special projects and other duties as assigned by Avel eCare Credentialing Manager.

REQUIRED EDUCATION and/or EXPERIENCE: 

• One year credentialing experience preferably in Telemedicine.
• CPCS Certification preferred.

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