Credentialing Specialist

University of Arkansas for Medical Sciences•Little Rock, AR

1d•Onsite

About The Position

The Credentialing Specialist supports the Professional Staff Office functions, including: recredentialing and privileging of physicians and affiliated health professionals; managed care credentialing; Credentials Committee documentation; administrative functions related to the Bylaws, Rules and Regulations, and Departmental Policies and Procedures; and regulatory compliance.

Requirements

Bachelor’s Degree in Business, Healthcare Administration, or Science, and/or related field plus 3 years in credentialing (medical staff services, provider enrollment, credentials verification organization or insurance plan credentialing) required.
High School, GED, and equivalent combination of education and experience (7 years with 3 years in required experience field(s).
Persons must have proof of legal authority to work in the United States on the first day of employment.

Responsibilities

Determines appropriate level of staff status for applications.
Advises Department Business Administrators.
Distributes initial and reappointment applications.
Requests additional documentation when necessary.
Ensures that time sensitive verifications used in credentialing process meet requirements; and facilitates proper review of files.
Prints and reviews scheduled reports from the credentialing database.
Enters terminations in credentialing database and moves folders accordingly.
Runs reports and analyzes data accuracy, recommending and making changes as needed.
Assists with credentialing database system development.
Ensures compliance of all credentialing activities.
Perform other duties as needed.