CVO Credentialing Specialist

CoxHealth•Springfield, MO

27d•Onsite

About The Position

Responsible for supporting the credentialing and privileging processes for medical staff and other credentialed practitioners in accordance with organizational policies, Medical Staff Bylaws, Rules and Regulations, and applicable accreditation and regulatory requirements. Ensures credentialing information and documentation are accurate, complete, current, and processed within established timeframes. Communicates professionally with providers and stakeholders, maintains confidentiality, identifies and escalates issues requiring additional review, and provides effective customer service in support of Medical Staff Services and organizational objectives. Performs or coordinates primary source verification of practitioner credentials in accordance with applicable organizational, accreditation, and regulatory requirements. Identifies incomplete information, discrepancies, adverse information, or other items requiring additional review and obtains appropriate documentation and follow-up. Communicates application requirements, outstanding items, deadlines, and status information professionally and effectively with providers and other appropriate stakeholders. Identifies matters requiring additional review or escalation and appropriately communicates concerns to CVO leadership. Performs other duties as assigned in support of the CVO department and organizational objectives.

Requirements

High School Diploma or Equivalent
2 years' healthcare or related experience
Proficient computer skills, including Microsoft Office products, spreadsheet management, database management, and other technology used to manage credentialing and medical staff information.
Ability to learn and adapt to new software applications and technology.
Ability to communicate effectively and professionally, both orally and in writing, with providers, leadership, colleagues, and small groups.
Strong critical-thinking, analytical, and problem-solving skills.
Demonstrates a high degree of discretion and confidentiality when handling sensitive information.
Strong organizational skills and exceptional attention to detail.
Ability to prioritize competing responsibilities and manage multiple tasks simultaneously.
Ability to effectively manage large volumes of information, documentation, and time-sensitive records.
Excellent time-management skills with a strong focus on meeting established deadlines.
Excellent customer service and interpersonal skills.
Proficient use of English grammar and spelling, including the ability to compose, proofread, and edit professional correspondence and documents.
Ability to work cooperatively and effectively as a member of a team.
Ability to work independently within established policies, procedures, and guidelines.
Ability to identify discrepancies, incomplete information, and potential compliance concerns and initiate appropriate follow-up.
Ability to appropriately identify and escalate matters requiring additional review or leadership involvement.

Nice To Haves

Associate’s Degree in healthcare, business, or related field or (2) two years of experience in a directly related field may be considered in lieu of the preferred degree.
Experience working and communicating directly with medical staff in a hospital or healthcare setting.
Experience with medical staff credentialing and privileging within the past five (5) years.
Experience utilizing credentialing or medical staff management software.
Certification with the National Association of Medical Staff Services (NAMSS).

Responsibilities

Supports the credentialing and privileging processes for medical staff and other credentialed practitioners.
Ensures credentialing information and documentation are accurate, complete, current, and processed within established timeframes.
Communicates professionally with providers and stakeholders.
Maintains confidentiality.
Identifies and escalates issues requiring additional review.
Provides effective customer service in support of Medical Staff Services and organizational objectives.
Performs or coordinates primary source verification of practitioner credentials.
Identifies incomplete information, discrepancies, adverse information, or other items requiring additional review and obtains appropriate documentation and follow-up.
Communicates application requirements, outstanding items, deadlines, and status information professionally and effectively with providers and other appropriate stakeholders.
Identifies matters requiring additional review or escalation and appropriately communicates concerns to CVO leadership.
Performs other duties as assigned in support of the CVO department and organizational objectives.