Credentialing Specialist

3 days ago


Rock Island, Illinois, United States UnityPoint Health Full time
Credentialing Specialist Job Summary

The Credentialing Specialist is a key member of the UnityPoint Health team, responsible for the timely processing and tracking of Medical Staff files, including primary source verification, review of information, and additional research as needed. This position serves as a liaison between providers, physician hospital organization (PHO), System CVO staff, and regulatory agencies.

Key Responsibilities:
  • Initial and reappointment credentialing for delegated credentialing processes
  • Send applications and record in SharePoint accordingly
  • Input data into credentialing software and keep appropriately updated
  • Prepare/Validate all privileging information is accurate and prepare for Credentials Committee discussion as well as Medical Executive Committee and local Board
  • Discuss any privilege delineations with Credentialing Committee Chair and other appropriate personnel prior to the Credentialing meeting
  • Assure required education for new privileges are met
  • Create new privilege delineation forms in accordance to national standards
  • Prepare packet for presentation at required approval meetings, obtain signatures
  • Notify appropriate members on provider approval and suspensions
  • Any extra requirements posed by the medical center such as restraint or fire safety training
  • Assure collection of Medical Staff Fees and Dues
  • Ensure life certifications are current
  • Ensure all EKG providers have privileges
  • Review terminations/notifications

Requirements:
  • High School Diploma or GED required
  • Excellent communication skills both written and verbal
  • Knowledge of hospital credentialing
  • Knowledge of regulatory requirements from TJC, NCQA, CMS
  • Minimum of 2 years of experience in a hospital/medical related role

Why UnityPoint Health?

At UnityPoint Health, you will find a culture guided by uncompromising values and an unwavering belief in doing what's right for the people we serve. Our competitive Total Rewards program offers benefits options like 401K match, paid time off, and education assistance that align with your needs and priorities, no matter what life stage you're in. We are committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation. We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience. Be an essential part of our core purpose to improve the health of the people and communities we serve.

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