Credentialing Specialist

NueHealth • Royersford, PA

6d

About The Position

Under the general supervision of the Director of Quality and the Administrator this role will be responsible for the coordination, administration, and quality controls of the initial credentialing and privileging processes for all the medical staff. Assignments are planned and executed with considerable independence in compliance with established policies and procedures, bylaws, regulations, and laws. In collaboration with the Director of Quality and the Administrator, provides consultation to facilities for ongoing facility reappointment and credentialing processes .

Requirements

• A minimum of three years of experience in managing medical provider credentialing and privileging processes
• Knowledge of credentialing and privileging principles, processes, procedures, and documentation
• Proficient in computer applications (Windows, Microsoft Office)
• Able to communicate effectively both verbally and in writing.
• Excellent information research skills.

Responsibilities

• Prepares, reviews and screens initial medical staff, allied health, new employees and contracted staff credentialing applications for completeness, accuracy, and appropriateness per policy
• Performs external research and conducts verification of all initial applicants
• Utilizing company policies and tools to provide facility guidance relative to the credentialing and privileging processes.
• Stays abreast of and applies knowledge of applicable federal and state laws and regulations and accreditation standards.
• Recommends pertinent updates and revisions to policies and procedures.
• Maintains the Clinical Services Program Policies and Procedures including revisions and updates
• Manages the distribution and update of Clinical Services Policies and Procedures
• Maintains an electronic archive of Clinical Services Policies and Procedures
• Provides administrative assistance as needed
• Prepares complete, accurate, and organized credentialing packets
• Delivers packets to the facilities 36 hours in advance of the scheduled Board Meeting
• Provides timely and accurate services to facilities related to ongoing credentialing and privileging processes
• Maintains current electronic files in alignment with company policy and structure
• Addresses customers and fellow workers in a service oriented and collaborative manner
• Secures credentialing matters to safeguard confidential and security of information
• Operates within the business unit budget
• Directly accountable to Director of Quality
• Contributes to the achievement of Strategic Development annual initiatives

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed