Credentialing Specialist

Intermountain Health

5d • $24 - $37 • Onsite

About The Position

The Credentialing Specialist (CS) is responsible for facilitating Intermountain Health’s centralized verification office (CVO) program and will serve as the primary credentialing liaison for hospitals, providers and/or network participating providers regarding credentialing services. Shift: M-F 8:00am-5:00pm. No weekends or holidays Essential Functions The CS will facilitate all aspects of Primary Source Verification program with accuracy and attention to detail. Including but not limited to written verification of applicants education and/or training, experience, They will review and ensure accuracy of provider information in credentialing software directly with the source for all applications. The CS processes initial credentialing and re-credentialing applications capturing primary source documentation in computer databases, prepares and keeps reports of credentialing activities like accreditation, membership, or facility privileges and makes sure the applications comply with applicable laws, regulations, procedures and policies. The CS needs to stay current on credentialing guidelines and make sure all records and applications are up to date and ready to be reviewed by the Hospital Medical Staff Office and Medical Staff Committees The CS will have frequent contact with system-wide medical staff services professionals, administrators and practitioners. The CS must keep the Central Verification Office (CVO) Leaders apprised of problems or concerns and perform other work-related duties as assigned. Incorporate accreditation and regulatory standards requirements into medical staff activities Work on maintenance of provider records including expirable items and other necessary documents.

Requirements

• Requires effective verbal and written communication skills and the ability to work well with a team.
• This position will utilize computer technology to perform job functions.
• Must have intermediate level experience with Word, Excel, Adobe and OneNote, and must be comfortable learning a sophisticated data base program.
• The incumbent must be able to work with a variety of health care professionals, able to function with minimal supervision, be self-motivated, keep confidences, have ability to adapt to frequent interruptions, have ability to solve problems and make decisions and possess organization and good communication skills.
• Working knowledge of TJC, NCQA standards as well as state and federal guidelines and requirements
• Graduation from High School or equivalent, required
• Knowledge of medical terminology required
• Medical Staff Credentialing
• Communication
• Organizing
• Health Insurance Portability & Accountability Act (HIPAA)
• Hospitals
• Health Care
• Data Entry
• Customer Service
• Critical Thinking
• Multi-Tasking

Nice To Haves

• Bachelor’s Degree from an accredited institution. Degree will be verified.
• Certified Provider Credentialing Specialist (CPCS) by the National Association of Medical Staff Services (NAMSS) or Certified Professional Medical Services Management (CPMSM) by the National Association of Medical Staff Services (NAMSS)
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within five (5) years of employment.
• Minimum of one year experience in administrative work.
• Experience as a medical staff coordinator, medical staff credentials specialist or privileging coordinator.
• One year experience in healthcare, legal or insurance environment.

Responsibilities

• Facilitate all aspects of Primary Source Verification program with accuracy and attention to detail.
• Review and ensure accuracy of provider information in credentialing software directly with the source for all applications.
• Process initial credentialing and re-credentialing applications capturing primary source documentation in computer databases
• Prepare and keep reports of credentialing activities like accreditation, membership, or facility privileges and makes sure the applications comply with applicable laws, regulations, procedures and policies.
• Stay current on credentialing guidelines and make sure all records and applications are up to date and ready to be reviewed by the Hospital Medical Staff Office and Medical Staff Committees
• Keep the Central Verification Office (CVO) Leaders apprised of problems or concerns and perform other work-related duties as assigned.
• Incorporate accreditation and regulatory standards requirements into medical staff activities
• Work on maintenance of provider records including expirable items and other necessary documents.

Benefits

• We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
• Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees