Credentialing Specialist

Planned Systems International, Inc. • Forest Park, GA

1d

About The Position

Cognito Systems, a Planned Systems International (PSI) joint venture, is seeking a skilled Credentialing Specialist. The purpose of this overall project is to provide centralized credentialing and privileging services and support to the United States Army Reserve (USAR) Command with initial entry credentialing, maintenance of credentialing and privileging, and support the Centralized Credentials Privileging Board’s review of completed credentials and privileging files.
Essential Functions and Job Responsibilities
Individuals will be responsible for managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health). This includes reviewing applications for completion, verification of state licensure, collecting information contained in the national physician data bank, collecting information from the Health Care Integrity and Protection Databank, collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals. Job duties will specifically also include:
Implementing USAR policies and standards to ensure that credentialing operations are complying.
Working with applicants and USAR staff to support and enhance credentialing functions.
Completing verifications and ensuring that the organization and staff are in accordance with USAR directives and industry trends and standard credentialing procedures.
Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results.
Generating and emailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing.
Data entry into CCQAS as the official system of record.
Prepare and maintain reports of employees based on accreditation, education, facility privileges, experience, membership and licensure, ensuring all employee information meets federal, state and local guidelines.
Maintain regular written and verbal correspondence with agencies, hospitals, malpractice carriers and medical review boards
Candidate may manage or supervise administrative aspects of the Contractor’s operations.

Requirements

• Two years of experience in performing the following functions: conduct administrative and record keeping aspects of the operation of engineering or technical projects / programs; apply knowledge of office management, methods and procedures in producing and maintaining documentation, correspondence, records or directives; work in regard to matters such as project / program progress and status documentation, budget, finance property accounting or personnel.
• Knowledgeable of requirements for verifying doctors' or other types of practitioners' credentials, processing the information and maintaining information data files.
• Have knowledge, and the maintain awareness, of current American Accreditation Healthcare Commission standards.
• Proficient with Microsoft Office software, to include, but not limited to Word, PowerPoint, Excel, Outlook, etc.
• Excellent verbal and written communication skills, including excellent customer relationship skill sets.

Nice To Haves

• Associate's degree or higher
• Experience in Quality Assurance preferred.
• Experience in the DOD credentials process preferred

Responsibilities

• Managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health)
• Reviewing applications for completion
• Verification of state licensure
• Collecting information contained in the national physician data bank
• Collecting information from the Health Care Integrity and Protection Databank
• Collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals
• Implementing USAR policies and standards to ensure that credentialing operations are complying.
• Working with applicants and USAR staff to support and enhance credentialing functions.
• Completing verifications and ensuring that the organization and staff are in accordance with USAR directives and industry trends and standard credentialing procedures.
• Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results.
• Generating and emailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing.
• Data entry into CCQAS as the official system of record.
• Prepare and maintain reports of employees based on accreditation, education, facility privileges, experience, membership and licensure, ensuring all employee information meets federal, state and local guidelines.
• Maintain regular written and verbal correspondence with agencies, hospitals, malpractice carriers and medical review boards
• Candidate may manage or supervise administrative aspects of the Contractor’s operations.

Benefits

• PSI offers full-time, benefits eligible employees a competitive total compensation package that includes paid leave, and options for employer sponsored group medical, dental, vision, short-term and long-term disability, life insurance, AD&D coverage, legal services, identity theft, and accident insurance.
• Flexible spending account and health saving account options offer pre-tax savings for qualified medical, dental, and vision expenses.
• The company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested.
• We invest in the professional growth of our employees through professional courses, certifications, and tuition reimbursement programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree