Credentialing Specialist

Ochsner Health • Lafayette, LA

7d • Onsite

About The Position

This job primarily assumes responsibility for the credentialing of new appointments and biennial reappointments of the Employed Physicians and Advance Practice Clinician of Ochsner Health System. Complies with strict guidelines and standards set by JCAHO, CMS and contractual agreements with health care providers. Assumes responsibility for Administration and Medical Legal aspects for employed Ochsner physicians. Coordinates medical staff committee meetings and performs administrative functions as an ASST to the Director of Medical Staff Services.
This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at Ochsner's discretion.

Requirements

• High School diploma or equivalent
• 3 years business experience at the level of administrative asst.
• Knowledge of credentialing principles, including the Medical Staff Standards of JCAHO and Credentialing Standards of CMS.
• Knowledge of medical and postgraduate education.
• Knowledge of various computer programs including Microsoft Word and the Internet.
• Must have computer skills and dexterity required for data entry and retrieval of patient information. Must be proficient with Windows-style applications and keyboard.
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process

Responsibilities

• Verifies all licensure at initial, reappointment, and upon expiration of license. Obtains copy of licensure as necessary.
• Reviews assigned initial and reappointment applications for medical staff and allied health staff to ensure all sections are complete and documentation is included.
• Updates database information, i.e., license and insurance renewals, address changes, status changes, Board approval, date, etc., within two to three days of receipt/change of information.
• Files credentialing documents and updated licensure and verifications of licensure upon receipt.
• Assists with recruiting activities including moving, new employed provider paperwork and other related activity to bring on a new provider.
• Greets office visitors in a professional and helpful manner.
• Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
• Complies with the Ochsner Health System Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED