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Credentialing Specialist

2 months ago

Scottsdale, Arizona, United States Tribal Health, LLC Full time
Position Summary

The purpose of this position is to provide credentialing skills to the physicians and advanced practice professional personnel as well as the service units for which they are credentialed. Accountable for the organization, maintenance, and verification of all aspects of the credentialing and licensing processes for healthcare providers.

Primary Function

The Credentialing Specialist manages the successful on-boarding and continual verification of physicians and advanced practice professionals' credentials at each location. Serves as liaison between each hospital's credentialing department and Tribal EM.

Position Responsibilities

  • Prepare reports of credentialing activities such as accreditation, licensing and facility privileges.
  • Maintain all necessary databases and applications used for input of new information and updates existing information.
  • Establish a positive and collaborative relationship with a customer service focus for incoming providers as they credential and on-board with Tribal EM.
  • Review facility-specific rules and regulations to ensure constant compliance with all internal processes.
  • Knowledge of credentialing programs and verification sites.
  • Verify healthcare credentials using primary source verification including, but not limited to, conduct necessary background checks, licensing boards, review license applications, obtain education and prior work history information, hospital affiliations and references.
  • Responsible for developing and maintaining positive, professional, collaborative relationships with clients and ensuring customer satisfaction.
  • Analyze, interpret, and draw inferences from research findings, and prepare reports.
  • Knowledge of related accreditation and certification requirements.
  • Work with service units, communicate, and problem solve to ensure compliance with all aspects of the client contract.
  • Knowledge of contract requirements regarding provider eligibility and requirements.
  • Promote and support a positive working relationship and effective team building
  • Attend meetings as requested or required by service unit administration and/ or Tribal Health.
  • Other duties as assigned

Minimum Mandatory Qualifications

  • Minimum of 2 years of experience directly related to hospital medical staff or managed care credentialing
  • Minimum of a high school diploma or GED require

Knowledge, Skills, Abilities and Other Qualifications

  • Proficient use of Microsoft Office (Word, Excel, and PowerPoint) and DocuSig
  • Demonstrated ability to communicate verbally and in writing throughout all levels of the organization, both internally and externally.
  • Strong communication skills
  • Ability to work well as a cooperative and supporting member of the team.
  • Ability to concentrate and pay close attention to details
  • Knowledge of, and sensitivity to, cultural and language differences
  • Excellent interpersonal skills in handling interactions with operational staff, providers, other agencies, groups, and team members.
  • Must be able to work as a team member and develop productive and cooperative working relationships with all members of the health care team.
  • A record of satisfactory performance in all prior and current employment as evidenced by positive employment references
  • Ability to perform other duties as assigned.

Work Environment

Physical demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the primary functions of this job. While performing the duties of this job, the employee may be required to frequently stand, walk, sit, bend, twist, talk, hear and perform repetitive motions. There may be prolonged periods of sitting, keyboarding, reading, as well as driving or riding in transport vehicles. Specific vision abilities required by this job include reading, distance, computer, and color vision. Talking and hearing are essential to communicate with clients, vendors and staff. Overnight travel may be required from time to time.

Mental demands:

There are a number of deadlines associated with this position. The employee must be able to handle frequent interruptions and must also multi-task and interact with a wide variety of people on various and, at times, complicated issues.

Confidentiality:

All employees must uphold all principles of confidentiality and patient care to the fullest extent. This position has access to sensitive information and a breach of these principles will be grounds for immediate termination.

Background Investigation:

This position may be subject to a background check in an effort to ensure compliance with public law "Indian child protection and family violence prevention act." Candidates for positions that require a background check must be able to successfully pass a background and character investigation in compliance with pl

Performance Expectations

In performance of their respective tasks and duties all direct or leased employees of Tribal Health, LLC are expected to conform to the following:

  • Uphold all principles of confidentiality to the fullest extent.
  • Adhere to all professional and ethical behavior standards of the healthcare industry.
  • Interact in an honest, trustworthy and respectful manner with patients, employees, visitors and vendors.
  • Participate in departmental staff meetings, quality management activities and educational programs.
  • Comply with Tribal Health, LLC policies and procedures.
  • Display respect and understanding for all those they interact with.

Disclaimer: The information in this position description has been designed to indicate the general nature and level of work performance by employees in this position. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position. Employees will be asked to perform other duties as needed.

Native American Preference: Preference in filling vacancies is given to qualified Native American candidates in accordance with federal law (Title 25, USC Section 472). Form BIA-4432 should be submitted with the application. For more information about Native American Preference in employment please click here.

Equal Opportunity Employer: Tribal Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. We value the skills, experience, and dedication that veterans bring to the workplace and qualified veterans are encouraged to apply. Tribal Health is also committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures. If you need assistance or an accommodation due to a disability, please let us know during the application process.



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