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Medical Credentialing Specialist
4 months ago
JOB SUMMARY: Contributes to the Hospital's mission by verifying physicians' applications for privileges and conducting background checks to ensure our physicians meet the competency standards determined by the medical department chiefs and Joint Commission standards. This administrative compliance position will impact hospital safety and physician engagement and satisfaction by appointing/reappointing providers efficiently and thoroughly.
Schedule Requirements:
- This is a hybrid or remote-only role.
- Remote-only candidates must live in Massachusetts and be able to come into the office 2-3 times per month for mandatory meetings.
- Hybrid employees work a few days in the office and at home.
- General business hours. Mon-Friday, 8-5 pm.
- The schedule may vary based on business needs.
QUALIFICATIONS:
Education/Experience
Required: (One of the following)
- Associate degree in healthcare or business with at least (1) one year of experience working in a medical staff office or directly relevant area involving enrollment physician credentialing in another setting
- Three (3) years of highly relevant experience, with at least (1) one of those years working in a medical staff office or a highly relevant area involving provider enrollment/ credentialing in another setting.
- Bachelor's degree in a highly relevant field with some experience working with physicians or credentialing.
Preferred: Credentialing experience
Other Skills/Knowledge Required:
- For safety and quality reasons, one must be able to read, write, and communicate effectively in English with patients, visitors, and fellow hospital team members.
- General understanding and knowledge of the Center for Medicare and Medicaid Systems (CMS), the Joint Commission (TJC), the National Association for Quality Assurance (NCQA), and the Massachusetts State Regulations as they pertain to credentialing of Medical Staff members and Allied Health professionals.
- Ability to problem solve and make decisions.
- Proven ability in word processing and Excel
- Excellent database and Internet navigating skills.
- Demonstrated attention to detail and accuracy.
- Excellent organization and planning skills
- Polished communication and customer service skills in writing, in person, and over the phone.
LICENSES, REGISTRATIONS, CERTIFICATIONS:
Preferred: Certified Provider Credentialing Specialist (CPCS)
OTHER JOB REQUIREMENTS:
Professional Commitment Requirements: Stay current on developments in the field and/or licensure through continuing education, participation in professional organizations, or a combination of both.
