Credentialing Specialist

Orlando Health • Orlando, FL

1d

About The Position

Responsible for the administration and coordination of all credentialing, reappointment/recredentialing and delegated credentialing activities. Ensures the needs of medical staff and managed care offices are met through efficient processes, assuring compliance to accreditation standards, government agencies, as well as Orlando Health bylaws, rules & regulations.

Requirements

• High school graduate or equivalent.
• Knowledge of medical terminology.
• Three (3) years experience credentialing/privileging or; One (1) year of credentialing/privileging experience and/or two (2) years of clinical experience.
• Proficiency in Microsoft Word, Excel, Internet and significant proficiency in credentialing data system.

Nice To Haves

• Associate degree in business, health care, accounting or related field may be substituted for two (2) years of experience.
• Bachelor degree in health, business or related field may be substituted for three (3) years of experience.

Responsibilities

• Performs credentialing functions as outlined by Orlando Health management in accordance with established policy, procedures, and protocols.
• Performs timely and accurate primary source verification in addition to credentialing functions.
• Completes accurate and timely data entry of all credentialing activity into credentialing database.
• Provides exceptional customer service to physicians and physician office staff members as well as internal customers, such as members of other departments. Educates physicians and physician office staff on the credentialing process and maintains ongoing contact with these individuals throughout the process.
• Identifies trends and assists in the development of action plans for purpose of performance improvement. Evaluates processes in departmental policies & procedures and makes recommendations for changes to management. Develop and distribute reports as necessary utilizing credentialing database. Timely completion of all assigned duties.
• Maintains credentialing and reappointment/recredentialing files.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards.
• Maintains compliance with all Orlando Health policies and procedures.
• Assumes responsibility for professional growth and development.

What This Job Offers

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