United States onlyLicensure, Certification, or Registration Requirements for Hire:
Certified Provider Credentialing Specialist (CPCS) preferred
Licensure, Certification, or Registration Requirements for continued employment:
Certified Provider Credentialing Specialist (CPCS) preferred
Experience REQUIRED:
Minimum of three (3) years previous credentialing and medical terminology experience in a hospital or managed care credentialing setting
Previous experience using a personal computer and various applications, including Microsoft Office Access, Word, and Excel and credentialing software
Experience PREFERRED:
Five (5) years of previous experience in credentialing in a health care environment
Previous experience with the application of JCAHO, URAC and NCQA guidelines
Certified Professional in Medical Services Management (CPMSM)
Education/training REQUIRED:
Associates or Bachelors degree or experience in lieu.
Education/training PREFERRED:Associates or Bachelors Degree in Business, Healthcare or closely related field
Independent action(s) required:
Expresses ideas and exchanges information clearly and concisely.
Demonstrates the ability to prioritize work assignments effectively and efficiently within the scope of the employee’s responsibility.
Effective development of relationships with other members of the team (i.e. non-clinical personnel, etc.)
Highly motivated individual with independent work habits.
Organizational skills, proficiency in MS Office Access, Word, and Excel and credentialing software, and numerous hospital databases with extreme attention to detail are critical indicators for success in this role.
Ability to multi-task in stressful and limited time constrained environment.
Must possess knowledge of local, federal and state laws and regulations and JCAHO standards related to position’s chief objective and demonstrate aptitude for compliance with VCUHS policies, procedures, and customer service philosophy.
Supervisory responsibilities (if applicable): N/A
Additional position requirements: N/A
Age Specific groups served: N/A
Physical Requirements (includes use of assistance devices as appropriate):
Physical: Lifting 20-50 lbs.
Activities: Prolonged standing, Frequent bending, Walking (distance), Reaching (overhead, extensive, repetitive)
Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking
Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Able to adapt to frequent change
EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.
