Mercy Health

  • Credentialing & Licensing Spec

    Requisition ID
    Other Allied Health
    Position Type
    Full Time
    Support Services
  • Overview

    Job Template Header


    We’re a Little Different


    Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.  


    We don’t believe in jobs at Mercy, we believe in careers that match the unique gifts of unique individuals; careers that not only make the most of your skills and talents, but also your heart.


    At Mercy, you’ll feel our supportive community every step of your day, especially the tough ones. We’re a team and love working that way. That team is expanding, and we currently have exceptional opportunities to help our communities grow.


    Responsibilities and Qualifications

    Performs functions necessary to ensure providers applications for licensure at specified state licensing boards are completed. Assists providers in completing applications for licensure as needed for Tele-medicine work. Performs all verifications necessary to complete license applications. Researches licensure requirements for new Mercy Virtual locations. Coordinates accurate verification of practitioner files for initial privileges and for renewal of privileges within established time frames and in accordance with the standards required by the accrediting/regulatory agencies for Mercy Virtual. This includes preparing and sending applications, gathering, entering and verifying information received in the application process and communicating verbally and written with applicants as necessary to complete their application. Performs other clerical duties and responsibilities for Mercy Virtual. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.


    1. Provides outstanding customer service to all providers during the licensing/credentialing process.
    2. Respects at all times the confidentiality of licensee/credentialing records and uses complete discretion when discussing licensing/credentialing matters, including malpractice, discipline and criminal history. Ensures all information is secured and all paperwork is disposed of in appropriate confidential trash receptacles.
    3. Researches requirements for licensure for new states as Mercy expands telehealth services.
    4. Gathers all required documents to fill in detailed required fields on both paper and on-line applications according to each regulatory board requirements.
    5. Completes applications for FCVS, state licensure, facility privileges, DEA, BNDD and malpractice insurance for Physicians involved in vAcute, vICU, vStroke, vMentalWellness, vKids, vHospitalists and ambulatory telemedicine across the Mercy System.
    6. Completes all required verifications of other licensure, education, training, testing, malpractice history, affiliations, work history, peer references, citizen status and identification documents according to each states requirements.
    7. Completes RN applications for state licensure for vAcute, vStroke, vEngagement, vKids and vICU RN’s. Processes required transcript requests, employment verifications and license verifications for each license.
    8. Specialist must maintain knowledge of all service lines they are licensing, as each service line requires different state licenses.
    9. Is responsible for individual pcard.
    10. Processes pcard payments and monthly statement resolution in a timely and accurate manner.
    11. Processes check and ACH payment requests as needed for applications with appropriate coding.
    12. Specialist must quickly redirect priorities based on go-live dates and needs as determined by leadership.
    13. Maintains accurate files, both electronic and paper, on all providers.
    14. Uses FedEx and certified mail to track applications.
    15. Assists providers with keeping CV’s current for licensing.
    16. Schedules appointments with providers for signing applications and fingerprinting.
    17. Processes initial/modification/recredentialing applications to completeness as determined by state, federal or accrediting agency guidelines and standards for review, recommendations and decisions by the appropriate organizational committees or bodies for all Mercy facilities.
    18. Communicate with providers regarding credentialing/licensing status and missing information.
    19. Maintains knowledge of the credentialing database and completes data entry correctly and timely.
    20. Analyzes verifications for content and generates follow-up requests for additional information if necessary and/or requested. Monitors status of verified information and provides information to appropriate personnel as designated by policy.
    21. Advises Managers and Supervisors of Mercy Credentialing and Data Center of any adverse or questionable information received and recommends follow-up action which may include review by risk management or general legal counsel.
    22. Maintains credentialing/licensing database to keep it current in regard to all changes in privileges, licenses, certifications, professional liability insurance requirements, and updates as needed for credentialing and licensing.
    23. Assembles delegated credentialing packets for Commercial and Internal customers.
    24. Maintains current privilege lists for all delegated sites and ensures lists are sent to delegated sites on a regular basis.
    25. Notifies providers and monitors reports of expired information and progress in obtaining updated information.
    26. Assists in credentialing and licensing projects and planning.
    27. Maintains good human relations by interacting appropriately and professionally during conflict or stressful situations in a manner that facilitates constructive resolutions.
    28. Maintains positive relationships with state license boards, medical staff offices, providers and co-workers across the Mercy system.
    29. Keeps management informed of inability to meet deadlines or difficulties in completing requirements for licensure/credentialing.
    30. Demonstrates an open attitude toward change and participates in the change process.
    31. Adheres to Mercy policies and procedures including attendance, dress code and safety and disaster plans.
    32. Keeps work areas neat and clean and respects quiet work zone areas.
    33. Performs other duties as directed.


    Because you’re committed to excellence, you understand the importance of being properly prepared for your role at Mercy. That’s why you’ll bring to your role the right set of qualifications:


    • Education: Bachelor’s Degree (Preferred). (Previous experience of at least three years may be substituted for education). High school diploma or equivalent required.
    • Experience: Minimum of three years previous general clerical experience preferably in credentialing, licensing or database entry. Applicant must be detail-oriented and able to work in a demanding and fast-paced work environment. Analytical experience preferred. 
    • Certification: Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional Medical Services Management (CPMSM) preferred.


    We’ll Support You at Work and Home


    Our foundations are built on dignity and respect. Modern Healthcare Magazine named us as a “top 100 places to work.” We go out of our way to help people feel welcomed.  We offer day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds to benefit-eligible co-workers, including those working 48 hours or more per pay period!


    What Makes a Good Match for Mercy


    Compassion and professionalism go hand-in-hand with us, along with exceptional quality care. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We’re also collaborative and are not afraid to do a little extra to deliver excellent care – that’s just part of our commitment. If that sounds like a fit for you as well, we encourage you to apply.


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