Human Resources Specialist - Credentialing

Central Florida Health Care•Winter Haven, FL

38d

About The Position

The Credentialing Specialist works with all clinical member staff and external sources to ensure compliance with CFHC Credentialing and Human Resources Policies, JC, HRSA and FTCA standards and guidelines and other applicable federal, state and local regulatory and/or accrediting agencies. The Credentialing Specialist is responsible to facilitate all aspects of credentialing, including Initial appointment, reappointment, monitoring, privileging for all LIP, OLCP and OCS. This position supports the general business operations of CFHC and its customers.

Requirements

Associates Degree in information technology, Human Resources Management, Business Administration, or 2 years of HR administrative experience required.
Attention to detail and problem-solving competencies
Strong analytical, problem solving, organizational, interpersonal, and communication skills required.
Expert proficiency in Microsoft suite of products (Outlook, Word, PowerPoint, and Excel).
Able to perform in a fast-paced environment while always maintaining excellent service.
Ability to handle sensitive information in a confidential manner.
Ability to work independently

Responsibilities

Maintains current knowledge of JC, HRSA, FTCA clinical staff credentialing standards and state and federal requirements
Reviews and maintains the confidentiality of information and materials that may include sensitive or adverse information
Leads and participates in credentialing projects, researching regulatory and industry standards to identify approaches to new or existing project implementation, and presenting research and recommendations to the RHRM
Provides and implements recommendations for process and procedure workflow changes
Researches and analyzes complex credentialing issues and develops and proposes solutions
Main contact between Managed Care and Credentialing for providers AHCA backgrounds (initial and renewals)
Facilitates Credentialing session during on-boarding with new hires
Manages all aspects of the Credentialing function; defines and implements processes ensuring HRSA compliance and audit ready preparedness
Manages all aspects of the Credentialing function and Credentialing Software
Organize and maintain file systems, credentialing files, correspondence, and other records
Maintain National Practitioner Database for administrative purposes including active employee database
Responsible for Verify Comply OIG verifications. The SAM's government report for all current employee's
Proactively formulate ideas and recommendations for system improvements
Conducts provider credentialing and re-credentialing, including performing Primary Source Verifications
Responsible for all verified information and prepares credentialing files
Disseminate information to other CFHC departments as required and maintains RegLantern w/required documents
Coordinates providers and clinical staff training and access to "RegLantern"
Compile, prepare, copy and distribute correspondence, memorandums to obtain information from a variety of sources
Assists with the credentialing / background process by communicating with new hires to get all needed HRSA and Joint Commission required credentialing and Privileging paperwork
Responsible for initial AHCA backgrounds and fingerprints for LIP's, Sr. Leaders, Board Members, and etc.
Performs ongoing monitoring of license status and state and federal sanctions of contracted and non-contracted providers and all clinical staff
Sets up and maintains provider information in online credentialing databases and RegLantern the electronic credentialing system
Maintain accurate and up to date credentialing provider files
Research colleges and Universities for verification of Educations
Manage and send out the 90-day competencies
Manage and send out the bi-annual competencies for all clinical staff
Run OIG report on all new employees and on all re-credentialed employees
Send daily credentialing communications to employee as needed
Prepare and Maintaining records of credentialing activities such as accreditation, membership and privileges
Responsible for the overall Credentialing and Privileging Committee meetings including presenting new hires, recredentialed employees, and meeting minutes.
Responsible for all requests for additions/deletions of privileges and/or changes in staff status and process through the Credentialing and Privileging committees
Utilize DocuSign for credentialing where possible
Edit credentialing and privileging forms and upload to HR Drive and DocuSign including checklist, privileging, health attestation and job descriptions
Create credentialing files for all new hires
Remove all terminated employee files from cabinets and Reglantern credentialing software program
Review for accuracy the AssureHire and Labcorp monthly invoices
Participate in projects and other duties as assigned

Benefits

Competitive Salary
Federal Student Loan Forgiveness:
PSLF - 10-year commitment, 120 loan payments and at the end of the commitment, the remaining loan is forgiven
Excellent medical, dental, vision, and pharmacy benefits
Employer Paid Long-Term Disability Insurance
Employer Paid Life Insurance equivalent to 1x your annual salary
Voluntary Short-Term Disability, additional Life and Dependent Life Insurance are available
Malpractice Insurance
Paid Time Off (PTO) - 4.4 weeks per year pro-rated
Holidays (9.5 paid holidays per year)
Paid Birthday Holiday
CME Reimbursement
401k Retirement Plan after 1 year of service (w/matching contributions)
Staff productivity is recognized and rewarded