Specialist-Credentialing

Overview

Job Summary

Assists with the operational administration of the credentialing and recredentialing/reappointment processes. Executes daily tasks based on implemented policies and procedures to assure compliance with applicable credentialing standards including The Joint Commission, NCQA and/or accrediting and regulatory bodies. Coordinates with appropriate leaders and facility/office contacts during initial appointment and recredential/reappointment process to meet set deadlines/committee approvals. Assists with file/report preparation and planning for Committee/Board review as well as other regulatory surveys/audits. Performs other duties as assigned.

Responsibilities

• Administers credentialing, recredentialing/reappointment and privileging process for designated providers assuring compliance with applicable accrediting and regulatory standards.
• Coordinates verification of documentation and associated information assuring accuracy and timely follow-up.
• Administers and maintains comprehensive practitioner databases and files with particular emphasis on integrity and completeness of documentation.
• Provides status reports, ad hoc queries, and other documents and summaries as requested.
• Provides administrative support to appropriate leaders and applicable committees to assist them in carrying out their responsibilities and complying with the requirements outlined in the Bylaws, Policy/Procedures and Hospital Rules and Regulations.
• Executes daily tasks and special assignments to assure compliance with production and quality standards as well as fostering team approach.
• Completes assigned goals.

Specifications

Experience

Minimum Required

• Three years office experience in a health care or business environment providing administrative or support services. Previous credentialing experience.

Preferred/Desired

Education

Minimum Required

• Completion of Associate's Degree in office administration, business, computer science or related field or equivalent experience.

Preferred/Desired

Training

Minimum Required

Preferred/Desired

Special Skills

Minimum Required

• Knowledge and proficiency in the use of personal computers including Microsoft Office solutions e.g. Word and Excel.

Preferred/Desired

Licensure

Minimum Required

Preferred/Desired