Credentialing Specialist
3 weeks ago
Catholic Health is one of Long Island's finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island.
At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes - to every patient, every time.
We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace
Responsibilities
The Credentialing Specialist will be responsible for auditing, data entry performed by clerical staff in Cactus Database, processing the initial and / or reappointment application in a timely manner, communicating with the applicant or re-applicant to keep them abreast on the status of their application and ensure processing is moving smoothly, following up with practitioner on missing items for packet, run all appropriate verifications related to the initial appointment / reappointment process, accurate and timely follow up with verifications - i.e. peer references, hospital affiliations, education, training, and work experience, accurate management of Cactus database for updating physician profiles and privileges at initial appointment and reappointment, prepare completed packets for Chief & Chairman / Director Review, post Credentials Committee / Board of Trustees follow up - i.e. updating privileges, status of applicant, generating appointment / reappointment letters, etc. and assist practitioners with questions when they call or come to our office.
Additional Responsibilities:
- Utilizes all available resources to reach sound decisions.
- Assumes responsibility for problems and initiates actions to solve them.
- Work with others toward shared goals including participation in department problem-solving and improvement activities.
- Bring issues related to the credentialing and/or recredentialing process to the attention of management in a timely fashion.
- Foster change initiatives to ensure continuous performance improvement and service excellence.
- Participate in Joint Commission preparation and NY State DOH Survey
- Participate in Managed Care Audits Assist in preparation and mailing of correspondence required for Credentialing, when necessary
- Provide support services and act as back up to clerical staff when necessary
- With appropriate training, accept additional related duties, as needed.
- Participate in education programs, in-service meetings, workshops, conferences, and committees.
- Keep abreast of current literature and professional trends
- Review and understand the Medical Staff Bylaws of each CH Facility Review and understand the Joint Commission Standards Review and understand the NCQA Standards
- 5 years of Credentialing experience in a hospital setting
- Proficient in Microsoft Office, including Word and Excel
- Must have the ability to prioritize and have good listening, written and oral skills
- Excellent customer service, oral/written communication, interpersonal, and organizational skills
- Well versed in the use of the Cactus Database CPCS (Certified Provider Credentialing Specialist)
- Knowledge of Cactus a plus Knowledge or experience with credentialing processes desirable
Pay Range
USD $27.00 - USD $30.00 /Hr.
Qualifications
This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate's qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.
At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.
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