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Credentialing Specialist
2 months ago
We are seeking a highly skilled Credentialing Specialist to join our team at NavitsPartners. The successful candidate will be responsible for facilitating all aspects of provider credentialing, ensuring compliance with organizational policies and procedures, and maintaining accuracy and data integrity.
Key Responsibilities- Initial Appointment and Reappointment Process: Facilitate the initial appointment and reappointment process for all providers, ensuring timely and accurate completion of credentialing requirements.
- Credential Audits: Conduct regular credential audits to ensure compliance with organizational policies and procedures, identifying areas for improvement and implementing corrective actions as needed.
- Clinical Privileging: Manage clinical privileging for Medical Staff, Allied Health Professionals, and other providers, ensuring that all necessary documentation and approvals are in place.
- Credentialing Software Management: Utilize MDStaff credentialing software application to perform and monitor credentialing and background checks, maintaining accuracy and data integrity in all credentialing activities.
- Regulatory Compliance: Interpret and ensure compliance with accrediting and regulatory agencies' requirements, developing and maintaining a working knowledge of statutes and laws relating to credentialing.
- Collaboration and Communication: Collaborate with internal stakeholders to address credentialing-related issues and concerns, maintaining confidentiality and security of provider credentialing information.
- Education: Bachelor's degree in healthcare administration, business administration, or related field preferred.
- Certification: Certification in healthcare credentialing (e.g., Certified Provider Credentialing Specialist, CPMS) preferred.
- Experience: Minimum of 2 years of experience in provider credentialing in a healthcare setting.
- Skills: Proficiency in using credentialing software applications, preferably MDStaff; strong understanding of accrediting and regulatory agencies' requirements (e.g., Joint Commission, NCQA); excellent organizational skills and attention to detail.
