REPORTS TO: Chief Quality and Compliance Officer
SUMMARY: Credentialing specialist processes credentialing and re-credentialing applications for health care providers.
Duties or Responsibilities:
- Oversee the initial credentialing process for new practitioners.
- Verifies educations and training, licensure and certification, professional references, and other credentials as required through external organizations and agencies to obtain necessary documentation.
- Manage the re-credentialing process for current practitioners, including verifying updates to education and training, licensure and certification, and other credentials required.
- Coordinating with practitioners to obtain necessary documentation, as well as reviewing and evaluating the updated credentials.
- Maintain and update practitioner files to ensure compliance with accrediting and regulatory bodies.
- Serve as a resource for practitioners and staff on credentialing and privileging-related matters. This may involve answering questions and providing guidance on the credentialing and privileging processes, as wells as assisting with the completions of required documentation.
- Development and implementation of policies and procedures related to credentialing and privileging, as well as leading.
- Chairs the Credentialing Committee.
- Provides leadership to and is accountable for the performance of managers and/or senior level professional staff.
- Assist with the OPPE and FPPE process.
- Bachelor’s degree preferred or equivalent experience.
- At least 5 years of experience in credentialing and privileging in a healthcare setting., with experience in a leadership of supervisory role preferred.
- Strong attention to detail and organizational skills.
- Manage multiple tasks and prioritize effectively.
- Excellent communication and interpersonal skills.
- Collaborate with practitioners, staff, and external organizations.
- Proficiency in Microsoft Office and credentialing databases.
- Strong understanding of accreditation and regulatory standards for healthcare organizations.
- Ability to interpret and apply regulatory standards to the credentialing process.
- Experience with process improvements and the development of policies and procedures a plus.
- Diversity – Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
- Ethics – Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
- Analytical – Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs workflow and procedures.
- Attendance/Punctuality – Is consistently at work or on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.
- Customer Service – Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
PGYSICAL AND WORK ENVIRONMENT:
- Frequently requires to stand.
- Frequently requires to walk.
- Frequently requires to sit.
- Frequently required to utilize hand and finger dexterity.
- Frequently required to climb, balance, bend, stoop, kneel or crawl.
- Frequently required to talk or hear.
- The employee must occasionally lift and/or move more than 10 pounds.
- Specific vision abilities required by this job include Close vision; Distance vision, Color vision; Peripheral vision; Depth perception and ability to adjust focus.
I gave read the foregoing job description and understand the responsibilities of the ob. I agree that I am able to perform the essential duties of this position.