Headquartered in Phoenix, Integrated Medical Services is a team of 400 employees and a physician-led organization united through its providers’ commitment to high-quality innovative health care. Each day is a new day for ground-breaking ideas and unparalleled opportunity. Ours is a culture focused on what we can accomplish today, and where it can lead us tomorrow.
Integrated Medical Services, Inc. is currently searching for a professional, compassionate and knowledgeable individual to fill the position of Credentialing Specialist at our Corporate Office in Phoenix. The Credentialing Specialist is responsible for performing and maintaining timely, accurate and complete third party payor credentialing and hospital privileging for assigned IMS providers. In this capacity, this individual ensures accurate, timely and complete submission of health plan and hospital credentialing/re-credentialing and privileging information/applications to external designees for the physicians and allied health professionals within IMS.
*This is a hybrid position after training
- Perform all activities related to credentialing, re-credentialing and monitoring IMS physicians and allied health practitioners. Credentialing includes, but is not limited to, the timely processing of all paperwork and applications necessary to obtain hospital privileges and participation on all necessary insurance plans for practitioners who practice under IMS, Inc. whether contracts are held by IMS, individual practices, or individual providers.
- In conjunction with Brokers, completes activities related to malpractice insurance for all IMS providers.
- Provide timely notifications to IMS or individually held contracted insurance plans, including but not limited to, adding/deleting new providers, adding/deleting practice locations and any other pertinent information to be supplied to insurance plans, etc.
- Process timely initial and reappointments to the medical staff at provided identified and requested hospitals, surgi-centers, etc. This includes the obtainment, organization and submission of all necessary paperwork, documents, etc. such as is needed to fulfill the requirements for hospital or free standing facility privileging at the various organizations.
- Gather, collate, copy and ensure filing of relevant documents needed to maintain all IMS provider files in a "current" status.
- Submit relevant copies of documents to hospitals and insurance plans to meet requirements in keeping their IMS provider files "current."
- Actively participate in departmental meetings, payor meetings, and with departmental process and procedure development and modifications.
- Work together with Revenue Cycle team resolving credentialing issues and keep providers' credentialing status current within health record system.
- Use technology to maximize process work efficiencies and effectiveness.
- 2-5 years minimum experience required, specifically in medical provider credentialing for contracted health plans and hospital privileging.
- 1-3 years minimum experience required - credentialing denials with contracted health plans.
- Knowledge and/or experience of the health plan websites, CAQH, Intelli App software program, licensing boards, NPPS (NPI), Medicare (PECOS), National Provider Data Bank and hospital CVO's.
- High school diploma or GED required.
- AA degree preferred.
Joining Integrated Medical Services is more than saying "yes" to making the world a healthier place. It’s discovering a career that’s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. Our hope is that each day you’ll uncover a new reason to love what you do. If this sounds like the workplace for you, apply now!
You can look forward to a generous compensation package including medical, dental, vision, short-term and long-term disability, life insurance, paid time off and a very lucrative 401K plan.
*IMS is a tobacco-free work environment
IMS is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, disability status, sexual orientation, gender identity, age, protected veteran status or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.