Credentialing Specialist

1 month ago

Norwood, United States HirePower Full time

Job Summary

We are looking for an individual to join our client’s team as a Credentialing Specialist. Responsible for coordination and preparation of medical staff functions; prepares for committee meetings, takes minutes, processes, and distributes appropriate correspondence and assists with the development, planning, and implementation of the credentialing and privileging process in addition to the analysis of each file upon completion. Assists in compliance with the accrediting and regulatory agencies (i.e., Joint Commission and NCQA) regarding credentialing and privileges while developing and maintaining a working knowledge of the statutes and laws. Ensures that all expirable are reviewed, obtained, and managed monthly according to the rules and policies. Maintains the confidentiality of all business/work and medical staff information. Assists in managing the flow of information between medical staff services, Credentials Committee and MEC Committee, medical staff leadership, and Chief Medical Officer. Manages the FPPE process and the integration of OPPE during reappointment.


Job Description

  • Coordinate the credentialing activities of the Medical Staff and Allied Health Staff, in accordance with the Medical Staff Bylaws, Credentialing Policies, and Procedures of the Hospital as well as the federal and state law, regulatory, and accrediting agencies.
  • Provide administrative support to Credentials, General Staff, and other Medical Staff committees and departments of the Hospital as directed.
  • Process requests for temporary privileges and monitor all follow-up, in accordance with policies and procedures.
  • Process requests for additional privileges and monitor all follow-up, in accordance with policies and procedures.
  • Process requests for one-time privileges, visiting physicians, and/or student observers.
  • Coordinate verification of professional liability coverage, medical licensure, board certification, BLS, ACLS, ATLS, and/or NRP certifications and DEA certification, as required.
  • Obtain updated PPD and annual AHP evaluations.
  • Assist with the coordination of the annual dues process.
  • Credentialing/Database management.
  • Assist customers in the absence of the Credentialing Assistant and/or Administrative Assistant.
  • Assist with Joint Commission accreditation preparation, as necessary.
  • Assist with coordination of yearly on-call schedule preparation and coordination of Department Director election (every two years).
  • Coordinate preparation and distribution of new committee roster (every two years) and yearly master calendar.
  • Assist with verifications of medical staff membership and clinical privileges of providers from other healthcare facilities.
  • Assist in the coordination of medical staff events and functions and other duties assigned.


Skills Required

  • Must have 5+ years of experience from a hospital/health system credentialing physicians and/or advanced practice staff.
  • Must be strong in Excel and have great attention to detail.
  • Understanding of what needs to be verified, Joint Commission accreditation rules, privileging, license verification, board certifications, and anything the provider is licensed to do
  • Excellent computer skills, including word processing, spreadsheet, and database management.
  • Must be able to multi-task, attention to detail, and strong interpersonal skills are required.
  • Must be able to work independently and exercise independent judgment regarding the credentialing and privileging of providers as well as other medical staff services’ decisions and can define problems, prioritize issues, and develop and implement solutions.
  • This individual must be a self-starter who functions well in a team providing leadership examples by demonstrating exceptional standards in issues such as teamwork and interpersonal relationship development, reliability and attendance, professional appearance, and commitment to and participating in quality improvement programs.
  • Must have strong computer experience with database management, Microsoft Office, and Windows applications.
  • Must have experience with the Joint Commission and other healthcare regulatory bodies.


Education/Training/Certifications

  • Required: High School Diploma or equivalent.
  • Preferred: Associate degree or equivalent combination of education and related experience.
  • Preferred Certifications & Licensure: CPCS or CPMSM


Additional Requirements

  • Shift Time: 8:00AM - 4:40PM / 5 days a week
  • Attire: Business Casual
  • This is completely an onsite position; remote work is not available.
  • Candidate must be open to obtaining a Flu Shot prior to starting
  • Candidate must be open to a 13-week contract.


We are an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status, or other characteristics protected by law.


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