Credentials Specialist 2 -- Medical Affairs -- General Hospital

Charleston Area Medical Center • Charleston, WV

76d

About The Position

Adhere to and apply standards outlined in the CAMC Medical Staff Governing Documents to ensure all applications are processed in accordance with accrediting body and other regulatory standards. Validate and analyze all expirable documents provided by medical, advanced practice professional, and clinical assistant (if applicable) applicants and credentialed providers through primary source verification.

Requirements

• High School Diploma or GED (Required)
• 1 year credentialing experience
• Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.

Responsibilities

• Complete pre-application reviews when assigned by Credentials Manager
• Assist providers with credentialing inquiries
• Process initial credentialing and re-credentialing applications
• Screen practitioners' applications and supporting documentation to ascertain eligibility
• Contract external sources for verification of credentials information, including licensing agencies, university and hospital training program administrators, certification boards, liability insurance carriers, hospital officials and credentials staff, and other practitioners
• Reliably document all data in credentialing software
• Ensure compliance with applicable laws, regulations, procedures, and policies
• Maintain confidentiality of credentials file, information, and peer review
• Assess requests for clinical privileges by applying credentialing criteria, knowledge of institutional criteria, and medical staff governing documents; seek guidance from Credentials Specialist III or Credentials Manager for next steps
• Monitor expiration dates for critical documents such as license, insurance, and notify providers of possible expiration; obtain current documents as appropriate
• Prepare credentialing files for review for appointment and reappointment, for presentation in Virtual Committee or DocuSign, calling attention to red flags
• Prepare appointment and reappointment letters

What This Job Offers

• Job Type: Full-time
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 101-250 employees