Credentialing Verification Specialist

Emory•Atlanta, GA

About The Position

Under general supervision, the Credentialing Verification Specialist coordinates credentialing activities for Medical Staff and Allied Health professionals and serves as a liaison between hospital departments and the medical staff. The role verifies practitioner files for initial appointments and recredentialing, reviews applications, and follows up to obtain missing information so applications are complete. The specialist maintains current Medical Staff Bylaws, Rules and Regulations, prepares schedules and agendas for medical staff and departmental meetings, attends meetings, transcribes and maintains minutes, and maintains the Medical Staff roster. The role enters and retrieves data using CAS/EHIS database management software, documents how to access computer files, and produces reports. It also submits required requests and reports to the National Data Bank, coordinates appointments and reappointments in compliance with hospital bylaws, coordinates with Q.A., and prepares for J.C.A.H.O. surveys related to the Medical Staff or credentialing area. Other related responsibilities may be assigned.

Requirements

High school diploma or equivalent and one year of credentialing experience in an acute care hospital, managed care organization, and/or credentialing verification organization; a bachelor's degree may be substituted for the experience.
Experience with word processing and database management computer applications.

Nice To Haves

Basic knowledge of accreditation standards and state and federal credentialing-related regulations.
Working knowledge of medical terminology.

Responsibilities

Coordinate credentialing activities for Medical Staff and Allied Health professionals.
Serve as a liaison between hospital departments and the medical staff.
Verify practitioner files for initial appointments and recredentialing.
Review applications and follow up to obtain missing information.
Maintain current copies of Medical Staff Bylaws, Rules and Regulations.
Prepare monthly schedules and agendas for medical staff and departmental meetings; attend meetings, transcribe and maintain minutes.
Enter and retrieve data using CAS/EHIS database management software.
Produce reports, maintain the current Medical Staff roster, and document how to access computer files.
Make required requests of and submit reports to the National Data Bank.
Coordinate credentialing for appointments and reappointments in compliance with hospital bylaws.
Coordinate with Q.A.
Coordinate preparation activities for J.C.A.H.O. surveys regarding the Medical Staff and/or credentialing area.
Perform related responsibilities as required.