Credentialing Specialist

County of Los Angeles•Los Angeles, CA

7d•Onsite

About The Position

LA Health Services is seeking a Credentialing Specialist to support the process of obtaining, verifying, and assessing the qualifications of physician and allied health professionals for patient care services. This role is crucial for ensuring that healthcare professionals meet the necessary standards for membership and privileges within the Professional Staff Association (PSA). The specialist will manage applications, verify credentials, ensure compliance with state and federal regulations, and maintain confidential records. This position offers the opportunity to contribute to a large, integrated healthcare system dedicated to providing extraordinary care to the diverse population of Los Angeles County.

Requirements

Three (3) years of recent, full time experience in a Medical Staff Services office at the level of the Los Angeles County class of Intermediate Clerk or higher.
Successful certification as a Certified Provider Credentialing Specialist issued by the National Association of Medical Staff Services will be required before final appointment.
A valid California Class C Driver License or the ability to use an alternative method of transportation when needed to carry out job related functions.
Required experience will need to be fully met at the time of filing, and clearly indicated on the application.

Nice To Haves

Additional credit will be awarded for experience beyond the Selection Requirements.

Responsibilities

Receives and processes applications for credentialing and privileging from licensed independent practitioners and allied health professionals applying for membership in the Professional Staff Association (PSA).
Notifies the respective department chair and the applicant of their status and time frames for completion.
Reviews applications for required documentation; verifies credentials, education, employment history, licensure, professional references, hospital affiliations and liability claims history by performing on-line queries from a variety of resources.
Ensures physicians, allied health professionals and other practitioners of a healthcare facility are properly licensed, trained, and certified as mandated by state and federal regulations.
Reviews requested privileges to ensure that appropriate criteria and training is documented for the privileges sought.
Monitors documentation of provisional applications for completion of proctoring; notifies the respective department chair and provisional members regarding their status and time frames for completion of proctoring.
Prepares summary report of each application for evaluation and review by the Credentials and Medical Executive Committees; identifies any potential adverse information.
Maintains application and credentialing files in a confidential manner; regularly enters credentialing information into the database to ensure information on credentialing, privileging, certifications, prerogatives and competencies are current; disseminates data to authorized personnel.
Prepares reports or credential files for periodic audits by Consolidated Accreditation and Licensure Survey and Office of Managed Care as requested; conducts internal reviews; and completes required tasks as necessary.
Generates letters to hospital affiliations and other agencies to obtain information of the practitioner's professional competency.
Responds to inquiries from other agencies requesting employment verification and relevant information on current and past members of the PSA.
Prepares reports for various committees as requested on a periodic basis.
Participates in the development and implementation of credentialing processes and procedures.