Credentialing Specialist - Full Time
About The Position
The Credentialing Specialist is responsible for verifying information for medical staff and allied health professionals during initial appointments, reappointments, and privilege delineation. The role maintains the credentialing database, ensuring records are complete and accurate, and produces reports on provider data accuracy and application status. The specialist provides ad hoc support for credentialing committee approvals and the granting and release of privileges. This position communicates with internal and external customers to obtain or provide information related to verifications, malpractice claims, and other relevant matters. It also supports compliance with accrediting and regulatory agencies, including The Joint Commission, by maintaining a working knowledge of applicable statutes and laws. The specialist serves as a liaison among hospital clinical departments, practitioner applicants, and external parties, and participates in process improvement initiatives and special projects.
Requirements
- Bachelor’s degree in business, healthcare administration, human resource management, or another related field.
- Knowledge of Microsoft Office.
- Demonstrated attention to detail.
- Forward-thinking mindset to anticipate and address potential challenges or opportunities.
- Strong critical-thinking and problem-solving abilities.
Nice To Haves
- Two years of prior credentialing experience.
- Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification.
- Knowledge of credentialing management software.
Responsibilities
- Verify information for medical staff and allied health professionals' initial appointments, reappointments, and privilege delineation.
- Maintain the credentialing database and ensure entered information is complete and accurate.
- Run reports regarding provider data accuracy and application status.
- Provide ad hoc support for credentialing committee approvals and the granting and release of privileges.
- Communicate with internal and external customers to obtain or provide information concerning verifications, malpractice claims, and other pertinent matters.
- Assist with compliance with accrediting and regulatory agencies, including The Joint Commission, by maintaining working knowledge of statutes and laws.
- Act as a liaison among hospital clinical departments, practitioner applicants, and external parties.
- Participate in process improvement initiatives and special projects to enhance credentialing procedures and outcomes.
Benefits
- Medical insurance, including prescription coverage
- Supplemental insurance
- Dental insurance
- Vision insurance
- Life and AD&D insurance
- Short- and long-term disability coverage
- Flexible spending accounts
- Retirement plans
- Tuition assistance
- Voluntary benefits, including access to group insurance rates and discounts
- Tuition discounts at Thomas Jefferson University after one year of full-time service
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
