Department: Credentialing and Practice management


Job Title: Credentialing Manager

Job Summary: Under limited supervision, oversees the operations of the Credentialing team and the radiologist on-boarding at Teleradiology Solutions to develop, manage and monitor processes and procedures that support the credentialing, re-credentialing, expirables data management, and delegated credentialing contract processes. Oversees all of the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies. Supervises credentialing staff in the day-to-day management of the overall credentialing process and database management. Prepare and manage the annual credentialing budget.

Job description:

Primary Source Verification:


  • Following Company instituted guidelines in checking physician backgrounds and work histories.
  • Reviewing each physician’s files with a clinical insight.
  • Query NPDB, AMA and FCVS for the physicians who have applied for staff privileges in Teleradiology Solutions.
  • Collect information necessary to conduct the Initial appointment and Primary Source Verification for the physician.
  • Conduct License Verifications of the states the physicians held at the time of applying privileges.
  • Coordinate Background check through License verifications, Staff privilege Verifications, obtaining Claims histories and Peer evaluations and verifications of educational backgrounds and requesting FCVS, AMA & NPDB.
  • Ensure consistent documentation and complete verification of the physicians.
  • Conduct the Initial appointment and the first reappointment after 1 year of initial appointment and subsequent reappointments every two years.
  • Preparing the Master Profile for the physicians with all the information on demographic, personal, professional, Educational and Immunization and Health Status records of the physicians.


Credentialing physicians:


  • Maintain, crosscheck and update Credentialing database with current licenses, DEA and professional liability Insurance Certificates and peer review files.
  • Requesting, Tracking and follow up on expiring Privileges and Licenses of the physicians.
  • Maintaining appropriate reports for the purposes of tracking essential documents to ensure that deadlines are achieved. Perform related responsibilities as required.
  • Under general supervision, manage overall operations of the credentialing workflow and quality control all aspects of the credentialing process of physicians to assure compliance with required workplace safety standards and with JCAHO guidelines.
  • Assist in the organizing and directing of a comprehensive and specialized credentialing programme to assure continued accreditation by JCAHO.
  • Sending the completed Initial & Re-credentialing applications to the clients within the required time limits. Ensures accuracy and completeness of all submitted documents
  • Maintaining a tickler of all the e-faxes received related to credentialing / Licensing
  • Steer  applications and/or supporting documents through an entire process and requests assistance to the clients, if necessary
  • Act as liaison with practitioners and Clients (Hospitals) to resolve physicians’ credentialing issues
  • Act as a trouble-shooter to identify problems before, during and after the credentialing process
  • Interacting with the Medical staff offices of the Clients for the approval and ongoing review of the physicians in their various (Credentialing Committee, Medical Executive Committee & Board of Directors) Meetings.
  • Serve as Initial point of contact for the clients on day-to-day credentialing issues and matters associated with the credentialing/accreditation process.
  • Respond to client / Physicians inquiries received by primarily through e-mail, letter or phone.
  • Produce regularly scheduled and ad-hoc reports on the physicians upon demand from the department supervisor




  • Training the team through direct experience in a credentialing-work related setting by providing them advanced knowledge of credentialing functions and systems, by inculcating the communication/interpersonal skills necessary to interface with all levels of managers, employees and professional staff from the clients’ side
  • Training on maintenance of database of the physicians
  • Trains and supervises the credentialing and the radiologist on-boarding team.


Radiologist On-Boarding:


  • Partner with the HR and the projects team to oversee the day-to-day operations of the radiologist on-boarding and go-live on the schedule.
  • Assess, identifies, and implements plans for a smooth on-boarding of the radiologists.
  • Communicate the go-live and the credentialing updates to the radiologists.
  • Maintains professional affiliations and enhances professional growth and development to remain current in changing healthcare trends as relates to management of clinic operations.


Desired Qualification:

  • Master’s degree in Healthcare administration
  • 10-15 years supervisory or management experience preferred.


Skills and experience:

  • Work requires strong management skills, must plan and direct the work of a diversified staff.
  • Experience bringing leadership development theory, credentialing and assessment into practice
  • Experience working with senior level HR and Business leadership
  • Must possess advanced interpersonal skills to effectively interface with all levels of staff as well as external business-related individuals.
  • Excellent written and oral communication skills required.
  • Computer skills


Location: Virtual

Reporting Authority: CEO/MD

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