Medical Staff Credentialing Specialist

4 weeks ago


Kalispell, United States Logan Health Full time

Job Description Summary: This position coordinates and supports the credential process for providers of Logan Health. Qualifications: Minimum of one (1) of the following required: Minimum of one (1) year experience in provider credentialing. Minimum of two (2) years’ experience in a medical setting. Associate’s degree in Business Administration or other related field preferred. Minimum of one (1) of the below certifications must be successfully obtained within three (3) years of hire: Certified Provider Credentialing Specialist (CPCS) Certification Certified Professional Medical Staff Management (CPMSM) Ability to type at least 65 wpm accurately and consistently required. Advanced working knowledge of Microsoft Office Suite required. Possess ability to learn other software as needed. Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently. Commitment to working in a team environment and maintaining confidentiality as needed. Excellent verbal and written communication skills including the ability to communicate effectively with various audiences. Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy. Job Specific Duties: Assists with the on-boarding process of Medical Providers. Coordinates the credentialing and privileging processes for AHP’s (Allied Health Providers). Processes provider-credentialing applications in accordance with accreditation standards, regulatory requirements, and LH policies and procedures. Researches, examines, enters data, files, and gathers all information to process received information to support the credentialing process. Verifies, researches, and responds to inquiries, from providers and other stakeholders, pertaining to provider participation and credentialing status. Responsible for primary source verification for medical school, residency, fellowship, NPDB, DSHS, FSMB as applicable to assigned area(s). Records minutes at assigned meetings, develops agendas, and houses records. Maintains confidentiality of files and information per department procedure. Initiates and supports the provider application process by sending, receiving, and analyzing practitioner documents. Performs data import to determine completeness in preparation for the credentials verification process. Responsible for gathering, verifying and evaluating highly confidential and sensitive health care practitioner credentials consistent with departmental guidelines and accreditation standards. Responds to all practitioner, client health plan and internal inquiries in a timely manner. Monitors expiring licensure, board and professional certifications and other documents pending expiration within the prescribed timeframe. Keeps leadership informed of potential credentialing issues. Performs administrative tasks as applicable to assigned area(s). The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job. Not all of the duties may be assigned to a position. Maintains regular and consistent attendance as scheduled by department leadership. Shift: Day Shift - 8 Hours (United States of America) Schedule Details: Please know schedules and shifts are subject to change based on patient care and department/organizational needs. Schedule: Logan Health operates 24 hours per day, seven days per week. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed. Notice of Pre-Employment Screening Requirements If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes: Criminal background check Reference checks Drug Screening Health and Immunizations Screening Physical Demand Review/Screening Equal Opportunity Employer Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources. Our people are everything. The amazing providers, employees, and volunteers at Logan Health gift this organization with their innovation, knowledge, and compassion. Together, we're connecting our community to trusted, quality care and helping to improve lives every day. Do you dream of living and working in a beautiful area surrounded by stunning scenery and endless recreation? Are you ready to evolve your career while working alongside passionate, talented, brilliant people? Join our remarkable team and create positive patient experiences every day


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