Credentialist III at Federation of State Medical Boards – DFW, Texas

General Responsibilities: The Credentialist III is responsible for collecting the required credentialing documents, and document any identified discrepancies against the standards established by the designated State Medical or Osteopathic board or other entity. This position must have an extensive understanding of FCVS policies and procedures and credentialing workflow processes. They must demonstrate high quality and production results for physician services and verification services responsibilities. The Credentialist III must be able to successfully manage relationships with physicians, institutions and other strategic partner groups. This position will also serve as back-up to the customer service representatives during peak call volumes. This position contributes to the overall success of the FSMB by enhancing the organization’s vitality and through services provided to state and osteopathic medical boards

Essential Job Functions:

• Review medical professional applications and interpret applicability for designated recipients
• Effectively interpret and apply FCVS credentialing workflow processes
• Perform necessary data entry
• Process Medical and Graduate Medical Education documents received
• Communicate with medical professional, institutions and external organizations in order to collect the necessary verifications for the FCVS profile
• Perform necessary follow-up actions for credentialing verification information
• Interact with other workgroups
• Add applicant documentation into credentialing profile as needed
• Compare source documents to application information for omissions and anomalies and action accordingly
• Review Physician Information Report for discrepancies and required actions
• Provide internal/external customer service according to established guidelines
• Maintain elevated level of performance metrics for productivity and quality

Other Specialized Duties as needed may be included but not limited to:

• Use ECFMG EMED software for International Medical Graduate requests
• Assist in coaching new credentialists with workflow processing
• Participate in testing workflow processes and technology
• Identify process or technology improvements that can improve productive and quality
• Assist in developing/documenting training material for existing or new processes or technology
• Assist in validating departmental Standard Operating Procedures (SOPs)
• Collecting information for NCQA certification processes as needed

Education: Minimum of Associates Degree or 3-4 years related work experience.

Experience: 3-4 years of office experience including 2+ years credentialing experience, Customer service skills, preferably in a health care or professional association setting. Typing/data entry skills of 45-50 wpm; working knowledge of Windows environment, preferably with Microsoft Office. Strong knowledge of FCVS profile processing.

Skills: The ideal candidate will possess excellent written, oral, decision-making/problem-solving and analytical skills with the ability to scrutinize and compare documents according to established procedures. In addition, the candidate must be able to prioritize job responsibilities, make judgments with a minimum of supervision and effectively listen and respond to telephone calls from physicians. He or she must also possess excellent interpersonal, organization, and customer service skills with a demonstrated ability to work professionally and productively.