Credentialing Specialist
About The Position
Individual will be responsible for managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health). This includes reviewing applications for completion, verification of state licensure, collecting information contained in the national physician data bank, collecting information from the Health Care Integrity and Protection Databank, collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals. Job duties will specifically also include: · Providing direct supervision to the support staff in administering all aspects of processing applications. · Implementing USARC policies and standards to ensure that credentialing operations are in compliance. · Working with applicants and USARC staff to support and enhance credentialing functions. · Completing verifications and ensuring that the organization and staff are in accordance with USARC directives and industry trends and standard credentialing procedures. · Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results. · Generating and mailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing. · Entering data in the CCQAS as directed.
Requirements
- Bachelor's Degree in a Healthcare, Quality Assurance, or related field and 3 years of experience, including experience with medical credentialing. An equivalent combination of education and experience may be considered in lieu of the degree.
- Good communication and interpersonal skills.
- Organization skills and ability to be detail-oriented and accurate in work produced.
- Skills with MS Office, i.e. Word, Excel, and/or PowerPoint.
- US Citizenship and ability to obtain a favorable National Agency Check with Inquiries (NACI) or Interim Secret clearance.
Nice To Haves
- Experience in the DOD credentials process.
- Experience with CCQAS.
- Leadership experience/ability/aptitude.
- Certification from National Association of Medical Staff Services (NAMSS) as a Certified Provider Credentialing Specialist (CPCS)
Responsibilities
- Managing the verification process for all healthcare professionals
- Reviewing applications for completion
- Verification of state licensure
- Collecting information contained in the national physician data bank
- Collecting information from the Health Care Integrity and Protection Databank
- Collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals
- Providing direct supervision to the support staff in administering all aspects of processing applications
- Implementing USARC policies and standards to ensure that credentialing operations are in compliance
- Working with applicants and USARC staff to support and enhance credentialing functions
- Completing verifications and ensuring that the organization and staff are in accordance with USARC directives and industry trends and standard credentialing procedures
- Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results
- Generating and mailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing
- Entering data in the CCQAS as directed
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
