How much does a Medical Staff Credentialing Specialist Sr make in the United States?

Processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Handles and resolves inquiries regarding credentialing information, process, or status. Requires a high school diploma. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor. Works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. Typically requires 1-3 years of related experience. View Medical Staff Credentialing Specialist Salary

Responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. Typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. View Medical Staff Credentialing Director Salary

Reviews and verifies medical bills and invoices with accounts receivable ledger and patients. Ensures record accuracy, follows up, and makes necessary revisions. Processes changes in information system to support accurate and efficient billing process and financial close. Follows proper medical and insurance claim processes. Typically requires a high school diploma or equivalent. Typically reports to a supervisor or manager. Works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. Typically requires 1-3 years of related experience. View Medical Billing Specialist Salary

Researches and designs criteria to determine policy guidelines used in review of patient cases to ensure only medically appropriate services are reimbursed. Recommends a policy and process that ensure alignment with company guidelines and nationally accepted medical/coding standards. Establishes the proper codes to use for claims processing. Responds to questions from medical staff and communicates details about policy and guidelines. Requires a bachelor's degree. Typically reports to a supervisor or manager. Requires Registered Nurse RN. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. Typically requires 2 to 4 years of related experience. View Medical Policy Specialist Salary

Provides professional nursing care to assigned patients. Records patient histories, performs various diagnostic tests, administers medications, and develops patient care plans in conjunction with other medical professionals. Assists physicians during examinations and procedures, operating and monitoring medical equipment as necessary. Observes patients' progress and records observations in patient medical records. Promotes patients' independence by teaching patients and families to understand conditions, medications, and self-care skills. May focus on a specific medical specialty. May require a bachelor's degree in nursing. Requires a valid state Registered Nurse (RN) license. Typically reports to a manager or head of a unit/department. Work is generally independent and collaborative in nature. Contributes to moderately complex aspects of a project. Typically requires 4-7 years of related experience. View Staff Nurse - RN III Salary