Credentialing and Verification Office Specialist
1 month ago
Title: Med Saff Credentialing and Verification Office Specialist
Years of Experience: 3 years min, ideally 5+ years
Certification: Medical Services Management (CPMSM) and/or Provider Credentialing Specialist (CPCS) certifications or equivalent of 3 years experience
Remote position - May be required to come onsite if does not hold Medical Services Management (CPMSM) and/or Provider Credentialing Specialist (CPCS) certification.
MDStaff - Credentialing Software Experience
Dept: 7625 Medical Staff Services
Position Summary:
Assist the System Director, Credentialing and Medical Staff Services, in the credentialing and verification upon initial application and reapplication to Memorial Health Hospital Medical Staff. Works with their leader to improve the credentialing and verification process, streamline hospital privileging and support managed care credentialing. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.
Minimum Qualifications:
Education:
•Bachelor's degree in business or health related field is desirable.
Licensure/Certification/Registry:
•Successful completion and ongoing maintenance of the Medical Services Management (CPMSM) and/or Provider Credentialing Specialist (CPCS) certifications.
Experience:
•A minimum of 3-5 years experience in medical staff services
•Proven experience in maintaining collegial working relationships with physicians, allied health professionals and members of the leadership team.
Other Knowledge/Skills/Abilities:
•Working knowledge of medical terminology is required.
•Excellent verbal and communication skills are required.
•Proven team player.
Scope of Supervision:
Directly supervises 0 employees; indirectly supervises employees
Principle Duties & Responsibilities:
1. Responsible for credentialing Medical Staff initial applicants and reapplicants to Memorial Health Hospitals under the oversight of the System Director, Credentialing and Medical Staff Services.
2. Supports Memorial Health Managed Care with their provider credentialing for internal and external managed care credentialing needs under the oversight of the System Director, Credentialing and Medical Staff Services.
3. Overseas the practitioner credentialing database ensuring accurate and current information is available to all stakeholders.
4. Participates in the development and implementation of credentialing processes and procedures.
5. Audits, assesses, procures, implements, effectively utilizes and maintains practitioner/provider credentialing processes and information systems (e.g., files, reports, minutes, databases) by analyzing the needs and resources of medical services/credentialing.
6. Supports MH affiliate hospital Medical Staff Offices in the privileging process.
7. Ensures that policies, procedures and mechanisms to support the credentialing process in accordance with Medical Staff Bylaws, Rules and Regulations and in compliance with standards of all external regulatory and accrediting bodies.
8. Provide administrative support required to ensure effective management and coordination of the medical/allied health professional staff credentialing processes.
9. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values:
•SAFETY: Prevent Harm - I put safety first in everything I do. I take action to ensure the safety of others.
•COURTESY: Serve Others - I treat others with dignity and respect. I project a professional image and positive attitude.
•QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance. I work with others to achieve superior results.
•EFFICIENCY: Reduce Waste - I use time and resources wisely. I prevent defects and delays.
10. Assist the System Director, Credentialing and Medical Staff Services in the management of data to support the peer review process.
11. Maintain cooperative and supporting working relationships with all individuals who have involvement with organized the Credentialing and Verification Office.
12. Maintain a commitment to the MHS mission vision, values, goals and behavioral standards.
13. Performs other related work as required or requested.
The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform tasks other than those specifically presented in this description.
-
Credentialing Specialist
3 weeks ago
Springfield, Illinois, United States Springfield Hospital Full timeCredentialing Specialist Job DescriptionThe Springfield Hospital is seeking a skilled Credentialing Specialist to support departmental activities and ensure quality in conducting, maintaining, and communicating practitioner credentialing and privileging. This role is critical in ensuring medical staff functions are compliant with internal bylaws, governing...
-
Credentialing Specialist
4 weeks ago
Springfield, Illinois, United States Citizant Full timeCredentialing SpecialistAt Citizant, we are seeking a skilled Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in ensuring the smooth operation of our Personal Identity Verification (PIV) card enrollment process.Key Responsibilities: Schedule appointments and service walk-ins for PIV card activations,...
-
Credentialing Specialist
4 weeks ago
Springfield, Illinois, United States Springfield Hospital Full timeCredentialing Specialist Job DescriptionAt Springfield Hospital, we are seeking a highly skilled Credentialing Specialist to join our team. The successful candidate will be responsible for ensuring the quality and integrity of our healthcare services by conducting, maintaining, and communicating practitioner credentialing and privileging.The ideal candidate...
-
Credentialing Specialist
1 month ago
Springfield, United States Springfield Hospital Full timeJob Type Full-time Description The Credentialing Specialist will: Support departmental activities to ensure quality in conducting, maintaining, and communicating practitioner credentialing and privileging while ensuring medical staff functions are compliant with internal bylaws, governing bodies and external regulatory agencies. Serve as an essential link...
-
Pharmacy Assistant
3 weeks ago
Springfield, Illinois, United States Specialist Office Full timeJob DescriptionAt Specialist Office, we are seeking a highly skilled Pharmacy Technician to join our team. As a Pharmacy Technician, you will play a vital role in ensuring the smooth operation of our retail pharmacy.Mandatory Requirements:3 years of experience as a pharmacy technicianExperience working in a retail pharmacy is a mustExperience assisting...
-
Medical Credentialing Specialist
4 weeks ago
Springfield, Vermont, United States Springfield Hospital Inc. Full timeJob DescriptionAt Springfield Hospital Inc., we are seeking a highly skilled Credentialing Specialist to join our team. This role is responsible for ensuring the quality and integrity of our healthcare services by properly credentialing and privileging healthcare professionals.The ideal candidate will have a strong background in medical credentialing...
-
Government Badging Credentialing Specialist
4 weeks ago
Springfield, New Jersey, United States Citizant Full timeJob Summary:Citizant is seeking a skilled Government Badging Credentialing Specialist to join our team. As a key member of our organization, you will be responsible for managing the enrollment process for Personal Identity Verification (PIV) cards, ensuring the accuracy and security of sensitive information.Key Responsibilities:Schedule appointments and...
-
Medical Staff Credentialing Specialist
4 weeks ago
Springfield, Illinois, United States HexaQuEST Health, Inc. Full timeJob SummaryWe are seeking a highly skilled and experienced Medical Staff Credentialing Specialist to join our team at HexaQuEST Health, Inc. The successful candidate will be responsible for credentialing medical staff initial applicants and reapplicants to Memorial Health Hospitals under the oversight of the System Director, Credentialing and Medical Staff...
-
Electronic Visit Verification Support Specialist
4 weeks ago
West Springfield, Massachusetts, United States Tempus Unlimited Inc. Full timeJob Title: Electronic Visit Verification Support SpecialistTempus Unlimited, Inc. is a nonprofit organization that provides community-based services to empower children and adults with disabilities to live as independently as possible in the least restrictive environment.Job Summary:We are seeking a highly skilled and motivated Electronic Visit Verification...
-
West Springfield, Massachusetts, United States Tempus Unlimited Inc. Full timeJob Title: Electronic Visit Verification Department SpecialistTempus Unlimited, Inc. is a nonprofit organization that provides community-based services to empower children and adults with disabilities to live as independently as possible in the least restrictive environment.The Electronic Visit Verification Department Specialist will support the Tempus EVV...
-
Medical Facility Credentialing Specialist
4 weeks ago
Springfield, Massachusetts, United States Behavioral Health Network Full timeThe Medical Facility Credentialing Specialist is a key member of the Behavioral Health Network team, responsible for ensuring the smooth operation of facility credentialing processes. This role requires strong organizational and communication skills, as well as the ability to interpret complex regulations and guidelines. The ideal candidate will have a...
-
Admit Verification Specialist
4 weeks ago
Springfield, Illinois, United States CoxHealth Full timeAbout the RoleCoxHealth is seeking a highly skilled Admit Verification Specialist to join our team. As a key member of our Patient Access department, you will play a critical role in ensuring the accuracy and efficiency of patient admissions.Key ResponsibilitiesVerify patient information and admit orders to ensure accurate and timely admissionsPerform...
-
Medical Staff Credentialing Manager
4 weeks ago
Springfield, Georgia, United States Effingham Hospital Inc. Full timeJob SummaryEffingham Hospital Inc. is seeking a highly skilled Medical Staff Credentialing Manager to join our team. This role will be responsible for coordinating and managing administrative activities and processes of the Medical Staff and Allied Health credentialing in accordance with TJC, federal, state, and local guidelines, organizational and...
-
Electronic Visit Verification Support Specialist
3 weeks ago
West Springfield, Massachusetts, United States Tempus Unlimited Inc. Full timeJob Title: Electronic Visit Verification Support SpecialistDescription:Tempus Unlimited, Inc. is a nonprofit organization that provides community-based services to empower children and adults with disabilities to live as independently as possible in the least restrictive environment. Our mission is to encourage the inclusion of people with disabilities into...
-
Electronic Visit Verification Support Specialist
4 weeks ago
Springfield, Missouri, United States Tempus Unlimited Inc. Full timeJob SummaryTempus Unlimited, Inc. is seeking a highly skilled and motivated Electronic Visit Verification Support Specialist to join our team. As a key member of our support team, you will be responsible for providing top-notch support to our EVV program users, ensuring seamless implementation and ongoing support of our EVV solution.Key...
-
Electronic Visit Verification Specialist
4 weeks ago
Springfield, Missouri, United States Tempus Unlimited Inc. Full timeJob SummaryTempus Unlimited, Inc. is seeking a highly skilled and motivated individual to support our Electronic Visit Verification (EVV) program. As an EVV Program Support Specialist, you will play a critical role in ensuring the successful implementation and ongoing support of our EVV solution.Key ResponsibilitiesDevelop and maintain in-depth expertise...
-
Medical Facility Credentialing Specialist
4 weeks ago
Springfield, Massachusetts, United States Behavioral Health Network Full timeJob SummaryThe Medical Facility Credentialing Specialist is responsible for managing facility credentialing applications and maintaining a historical database of these applications for all payers contracting with BHN. This role requires strong analytical and communication skills to effectively execute responsibilities and meet established deadlines.Key...
-
System Verification and Validation Specialist
4 weeks ago
Springfield, Virginia, United States KBR Full timeJob Title:System Verification and Validation SpecialistKBR's National Security Solutions team provides high-end engineering and advanced technology solutions to our customers in the intelligence and national security communities.In this position, your work will have a profound impact on the country's most critical role – protecting our national...
-
West Springfield, Massachusetts, United States Tempus Unlimited Inc. Full timeJob SummaryTempus Unlimited Inc. is seeking a highly skilled and motivated Electronic Visit Verification (EVV) Program Support Specialist to join our team. As a key member of our EVV program, you will be responsible for providing technical support, implementing and rolling out the EVV solution, and ensuring ongoing compliance with Tempus quality and contract...
-
West Springfield, Massachusetts, United States Tempus Unlimited Inc. Full timeJob SummaryTempus Unlimited, Inc. is seeking a highly skilled and motivated individual to join our team as an Electronic Visit Verification (EVV) Program Support Specialist. In this role, you will play a critical part in supporting our EVV program, ensuring seamless implementation, and providing top-notch customer service to our users.Key...