BASIC PURPOSE OF THE JOB

Processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Maintains the hospital credentialing database system. Tracks license and certification expirations for all providers to ensure timely renewals.

REPORTS TO

• QM and Patient Safety Manager

JOB REQUIREMENTS

Supervisory Responsibilities: NO

Minimum Education: High School Diploma required.

License/Certification Required: NAMSS Certification preferred: CPMSM or CPS

Minimum Work Experience: 2+ years credentialing experience with hospital medical staff preferred

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

• Excellent verbal and written communication skills.
• Proficient with Microsoft Office Word and Excel
• Ability to focus for extended periods

DUTIES AND RESPONSIBILITIES

• Processing initial credentialing and re-credentialing applications
• Screen practitioners’ applications and supporting documentation to verify their eligibility
• Collecting information from National Practitioner Data Bank (NPDB), applicant, and other relevant sources.
• Identify discrepancies in information and conducting follow-ups
• Assist others with credentialing inquiries
• Keeps expiries items up to date (DEA, Insurances, licensee, board certification)
• Capture primary source documentation in appropriate sources and databases
• Ensure compliance with applicable laws, regulations, policies and procedures
• Prepares reports for review and action by appropriate Medical Staff committees.
• Maintain delineations for clinical privileges for medical staff and allied health professional
• Maintains and updates Cactus software database for credentialing
• Ability to work with other departments or physician offices
• Other duties as assigned
• Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
• Willingly accepts any other assignment that may be requested.
• Utilizes hospital resources and time respectfully and accountably.

PHYSICAL REQUIREMENTS

• Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.
• Light lifting, pushing and pulling is required for 10-20 lbs occasionally and frequent moving of objects of less than 10 lbs is required. Frequent sitting with some walking, standing, squatting, bending and reaching is required. Keyboard/computer use and/or repetitive motions may be required.

Come work where you can make a difference everyday.