United States onlyStatus
Full-Time
Standard Hours per Week
40
Job Posting Category
Administration
Job Posting Description
The Credentialing Specialist I will be responsible for:
- Processing applications for appointment, re-appointment, and mid-cycle change to the Medical Staff, House Staff, and Associate Clinical Staff, and requesting clinical privileges, as applicable, in a customer-focused, efficient, comprehensive, timely, and accurate manner.
- Reviewing and evaluating applications, including evidence of education, training, experience, and competency, to determine eligibility for membership and clinical privileges.
- Obtaining primary source verifications for all information submitted by the applicant or re-applicant.
- Recognizing, investigating, and validating discrepancies and adverse information obtained from the application, primary source verifications, or other sources; obtaining clarification and escalating concerns.
- Notifying applicants and re-applicants, and their coordinators, of any issues and maintaining contact with them throughout the process.
- Compiling, evaluating, and presenting practitioner-specific data collected for review by one or more decision-making bodies in a comprehensive and timely manner.
- Documenting, according to policy and procedure, applicants and re-applicants with potential issues in a holistic and comprehensive manner.
- Soliciting and obtaining information from the Department or Division Chief regarding applicants and re-applicants.
- Escalating concerns, according to policy and procedure, to the chain of command.
- Performing related credentialing functions, including ensuring all documents are maintained according to policy and procedure.
- Maintaining confidential credentialing files for all applicants and members of the Medical Staff, House Staff, and Associate Clinical Staff.
- Enrolling, maintaining enrollment, and terminating members of the Medical Staff, House Staff, and Associate Clinical Staff with the appropriate institutional malpractice carrier.
- Providing the highest level of service to all customers (internal and external) as demonstrated through the core values of the enterprise.
- Implementing office goals and objectives using continuous process improvement methods.
- Maintaining relationships and serving as a liaison between Medical Staff Services and clinical departments and divisions, and their Chief(s), enterprise-wide, to address questions and concerns.
- Teaching and providing expertise to managers, medical staff, and staff on credentialing processes, requirements, and regulations.
- Applying relevant Medical Staff Bylaws, Rules and Regulations, and any other relevant regulatory standards to the day-to-day functioning.
- Creating a customer-friendly and healthy work environment in support of employee engagement and well-being.
- Assisting in facilitating an efficient, productive, accountable, and customer and quality-oriented work environment using high-reliability principles.
- Providing and ensuring the highest level of service to all customers (internal and external) as demonstrated through the core values of the enterprise.
- Associate's Degree in the field of Medical Staff Services Science, Health Care Administration or a closely related field, or one year of basic technical training
- One year of related experience in a hospital or healthcare environment
- One year of experience in credentialing, provider enrollment or closely related field.
- Attention to detail, managing multiple tasks simultaneously, identifying and escalating concerns, and meticulous organization
- Candidates from New England region preferred.
