Medical Staff Credentialing Specialist

UAB St. Vincent's•Birmingham, AL

8d•Onsite

About The Position

Under limited supervision, the Medical Staff Credentialing Specialist serves as an essential link and resource between Practitioners, Senior Leaders, Departments, and hiring Stakeholders to coordinate the operational processes and ongoing credentialing, privileging and medical staff governance functions of the Medical Staff Office. Responsible for review, analysis and follow-up of credentialing and privileging applications, maintaining strict confidentiality and ensuring compliance with organizational policies and accrediting and regulatory agencies. Handles a range of specialized duties in the administration of credentialing and privileging requirements and processes, including, but not limited to, coordinates receipt of credentialing and privileging information; completing primary source verifications of credentialing information: coordinates credentialing pre-committee and end-of-committee processes to ensure notification to practitioners, departments and stakeholders. Researches and analyzes credentialing and privileging records to assess the suitability of the practitioner with meeting eligibility criteria and to ensure compliance with accreditation guidelines, state regulations and policies. Escalates concerns or issues identified. Acts as a resource and liaison by guiding practitioners and sponsoring departments/hiring stakeholders through credentialing and privileging processes and medical/clinical practice licensure requirements. Actively identifies credentialing issues/delays and proactively triage/resolves/communications with practitioners and sponsoring departments/hiring stakeholders to meet deadlines and anticipated start dates. Mains database and credentialing files to ensure records are accurate and current. Facilitates ongoing monitoring, primary source verification processes and communications with practitioners/departments to ensure credentialing expirables are current, including, but not limited to, state and federal license to practice renewals, board certifications, certificate of malpractice insurance, lifesaving certifications, and regulatory and required practitioner education/trainings. Mains strict confidentiality on all job-related matters. Performs other duties as assigned.

Requirements

High School Diploma or equivalent with 2 years' experience in credentialing, medical staff or related field.

Nice To Haves

Certified Professional Medical Services Management (CPMSM) preferred.
Certified Credentialing Specialist preferred.
Bachelor’s degree preferred.

Responsibilities

Serve as an essential link and resource between Practitioners, Senior Leaders, Departments, and hiring Stakeholders to coordinate the operational processes and ongoing credentialing, privileging and medical staff governance functions of the Medical Staff Office.
Review, analyze and follow-up of credentialing and privileging applications, maintaining strict confidentiality and ensuring compliance with organizational policies and accrediting and regulatory agencies.
Coordinate receipt of credentialing and privileging information.
Complete primary source verifications of credentialing information.
Coordinate credentialing pre-committee and end-of-committee processes to ensure notification to practitioners, departments and stakeholders.
Research and analyze credentialing and privileging records to assess the suitability of the practitioner with meeting eligibility criteria and to ensure compliance with accreditation guidelines, state regulations and policies.
Escalate concerns or issues identified.
Act as a resource and liaison by guiding practitioners and sponsoring departments/hiring stakeholders through credentialing and privileging processes and medical/clinical practice licensure requirements.
Actively identify credentialing issues/delays and proactively triage/resolve/communicate with practitioners and sponsoring departments/hiring stakeholders to meet deadlines and anticipated start dates.
Maintain database and credentialing files to ensure records are accurate and current.
Facilitate ongoing monitoring, primary source verification processes and communications with practitioners/departments to ensure credentialing expirables are current, including, but not limited to, state and federal license to practice renewals, board certifications, certificate of malpractice insurance, lifesaving certifications, and regulatory and required practitioner education/trainings.
Maintain strict confidentiality on all job-related matters.
Perform other duties as assigned.