Specialist-Credentialing Senior

Job Summary

Supports management with operational administration of the system credentialing and recredentialing/reappointment process. Monitors and executes daily tasks based on implemented policies and procedures to assure compliance with applicable credentialing standards including The Joint Commission, NCQA and/or accrediting and regulatory bodies. Supports management by assisting with the following: committee preparation, facilitation and follow-up for committee review, preparation and participation in audits/surveys and subsequent system updates.

Job Responsibilities

•    Administers credentialing/recredentialing/reappointment process for designated providers assuring compliance with applicable accrediting and regulatory standards. Executes the process in accordance with appropriate bylaws, hospital rules, regulations, and policies/procedures to assure that only qualified practitioners provide care.
•    Coordinates verification of documentation and information assuring accuracy and timely follow-up.
•    Administers and maintains comprehensive practitioner database with particular emphasis on integrity and completeness of documentation.
•    Provides status reports, ad hoc queries, and other documents and summaries as requested.
•    Provides administrative support to appropriate leaders and applicable committees to assist them in carrying out their responsibilities and complying with the requirements outlined in the Bylaws, Procedures, and Hospital Rules and Regulations.
•   Executes daily tasks to assure compliance with production and quality standards.
•    Completes assigned goals.

Minimum Required Experience

Three years of Credentialing experience required.

Minimum Required Education

Completion of Associate's Degree in office administration, business, computer science or related field or equivalent experience.

Minimum Required Special Skills

Knowledge and proficiency in the use of personal computers including Microsoft Office solutions e.g. Word and Excel.

Minimum Required Licensure

CPCS or CPMSM Certification is required to be obtained within one year of hire.