Job Description:

• Collect source documents required to initiate verification process; ensure completeness of submitted documentation.
• Research and conduct verification of provider's submitted documentation including but not limited to state licensure(s), education history, earned degrees, training, fellowship(s), specialty board memberships, military/veteran status, and practitioner history.
• Review and audit additional disclosure statements; verify any disclosed or discovered disciplinary or malpractice actions.
• Maintain communications between client and NextGen to ensure the source verification is completed within the allotted timelines in accordance with state requirements and contracted service level agreements (SLAs).
• Provide an accurate provider profile back to the client of the provider's eligibility to perform medicine within the respective state.
• Update and maintain accurate profile data; monitor the National Practitioner Data Bank (NPDB) on a monthly basis for any updates to profile; identify and document issues of concern.
• Ensure timely reporting to NextGen clients every three years of the state board Accreditation Cycles.
• Perform other duties that support the overall objective of the position.
  

• Associate degree.
• Or, any combination of education and experience which would provide the required qualifications for the position.

• 2+ years of experience in the medical services environment.
• 2+ years in a customer facing, customer service setting.
• 3+ years of credentialing experience.
• Or, any combination of education and experience which would provide the required equivalent qualifications for the position.
  

• Knowledge of: Credentialing principles and best practices; medical licensure and requirements; basic medical terminology; Health Insurance Portability and Accountability Act (HIPAA); Microsoft Office Suite.
• Skill in: Communication, interpersonal skills, analytical, research, problem resolution.
• Ability to: Maintain confidential information; gather, compile, and enter detailed data into a computer and complex report with attention to detail and accuracy; prioritize workload, meet deadlines, and multi-task while maintaining attention to detail; establish and maintain effective working relationships through collaboration and respect.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.