Credentialing Specialist - Medical Administration Days (M-F, 8am-5pm) - 40hrs/wk

umhealthwest•Wyoming, MI

1d•Onsite

About The Position

Perform credentialing and re-credentialing activities for all physicians and allied health providers. This includes the collection, scanning, and processing of new provider applications and reapplications, which involves background checks, state licensure checks, National Practitioner Data Bank checks, peer reference forms, privileging, hospital verification forms, and primary source verifications. The role also involves data entry into credentialing software, preparation of files for the Credentials Committee, and generating department reports. Additionally, the specialist will present credentialing information, assist with audits and regulatory reviews, provide provider orientation, act as a departmental liaison, and maintain records of expired credentials and dues.

Requirements

High School Diploma required
Proficient in Microsoft Office Word, PowerPoint, Excel and Credentialing Software
Excellent oral and written communication skills
Excellent customer service ability

Nice To Haves

Bachelor’s degree preferred
CPCS certification preferred
1-3 years of experience in credentialing and privileging, preferred

Responsibilities

Accountable for all credentialing and re-credentialing activities for physicians and allied health providers.
Collection, scanning and processing of all new provider applications and reapplications.
Processing criminal background checks, state licensure checks, National Practitioner Data Bank checks, peer reference forms, privileging, hospital verification forms, and primary source verifications.
Data entry into credentialing software program.
Preparation of files to be sent to Credentials Committee.
Preparation of meeting agendas and minutes as required.
Present complicated information with regard to credentialing, re-credentialing and privileging to section chief, department chair and/or Credentials Committee.
Assist with credentialing audits and preparation for regulatory agency reviews.
Generate all department reports and lists as requested.
Provide orientation for providers (tour of hospital, review of policies, ID badge and other orientation duties).
Serve as primary data entry point/gatekeeper for departmental forms and reports
Serve as a department liaison for OMM Department.
Assist with General Staff and Physician meetings.
Processing of incoming department mail, requests, and verifications.
Maintenance of monthly expired credentials list (insurance, DEA and licensure for physicians and AHPs), annual dues, and forms.
Maintaining a current knowledge base of department processes, protocols and procedures.
Pursuing self-directed learning and continuing education opportunities.
Participating on committees, task forces, and work groups as determined by management.