Credentialing Specialist

Presbyterian Healthcare Services • New York, NY

8d • $18 - $27 • Onsite

About The Position

Presbyterian is seeking a Credentialing Specialist. This role conducts thorough background investigations for physicians and other providers applying for affiliation with PHS–Albuquerque and regional facilities. Responsibilities include reviewing applications for completeness and performing primary source verification of licensure, education, clinical training, board certification, disciplinary actions, malpractice history, and peer assessments of current competence. The specialist identifies issues requiring further follow‑up, manages the collection and processing of Medical Staff reappointments within required timeframes, and processes privilege updates and status changes. The role also maintains tickler systems to ensure timely processing and compliance with regulatory and accreditation standards, while keeping credentialing database information accurate and up to date for use across the organization.

Requirements

• High School Diploma.

Nice To Haves

• One to three years' experience in hospital medical staff or managed care credentialing preferred.
• Certification or eligibility for certification as a Current certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred.

Responsibilities

• Analyze practitioner applications and/or requests to ensure that required documentation/information has been submitted in order to initiate the primary source verification processes
• Conducts primary source verification of applicants' education, licensure, professional work history, medical malpractice history for the purpose of determining competency and eligibility to be awarded membership and/or privileges
• Prepares processed files for review by appropriate members of medical staff leadership, including identification of information that may require additional investigation
• Utilizes appropriate tracking tools for the purpose of ensuring timely completion of applications
• Collects/analyzes data from various sources to include with initial and/or reappointment applications. Such data includes but is not limited to focused professional practice evaluations, ongoing professional practice evaluations, and privileging eligibility criteria
• Process other credentialing requests, as assigned, in accordance with established policies and procedures
• Responsible for on-boarding and/or orientation of new Medical Staff members, according to established policies and procedures

Benefits

• All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
• Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees