Credentialing and Privileging Specialist

2 weeks ago


Wheat Ridge, Colorado, United States Intermountain Healthcare Full time
Position Overview:
This role is essential in providing continuous support and coordination, acting as a vital link between the Medical Staff, Medical Directors, and Administration. The individual will oversee the ongoing credentialing and privileging processes, along with various administrative duties for the Medical Staff, Medical Director, Administration, and Allied Health Professionals.

Work Schedule:
Monday to Friday during business hours, with no weekend or holiday shifts required.

Work Environment:
This position offers a hybrid work model, requiring in-office presence at least three days a week.

Key Responsibilities:
  • Manage the application and reapplication processes, ensuring that initial applications meet eligibility criteria for privileges.
  • Facilitate communication between the Credentialing Verification Organization (CVO) and care sites, maintaining an accurate and timely credentialing database.
  • Request and verify written documentation of applicants' education, experience, professional references, current and past licenses, insurance, and claims history directly from the source.
  • Support medical staff leadership in the selection and orientation processes, ensuring familiarity with key policies.
  • Assist in the development of bylaws and related policies for medical staff.
  • Coordinate logistics for medical staff meetings, including room reservations, catering, and notifications.
  • Maintain and distribute a medical staff newsletter and calendar, ensuring timely communication.
  • Document continuing education for medical staff and maintain records accordingly.
  • Prepare agendas, minutes, and follow-up correspondence for all medical staff committees.
  • Compile credentialing reports and action items for Board review, and communicate Board decisions to the medical staff.
  • Orient applicants regarding medical staff bylaws, policies, structure, and performance improvement processes.
  • Assist in setting annual goals and objectives for the Medical Staff Office aligned with the organization's strategic plan.
  • Support the preparation and monitoring of the department's annual budget.
  • Ensure compliance with accreditation and regulatory standards in all medical staff activities.
  • Safeguard provider file security to maintain confidentiality and protect peer review documents.
Qualifications:
  • High School diploma or equivalent required.
  • A minimum of two (2) years of experience in roles such as medical staff coordinator, credentialing specialist, or administrative assistant.
  • Certification as a Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) is required within four (4) years of employment.
Physical Requirements:
Includes hearing, lifting, manual dexterity, pulling/pushing, vision, sitting, speaking, squatting/kneeling, standing, and walking.

About Us:
Intermountain Healthcare is committed to fostering a culture of wellness and providing a comprehensive benefits package that supports the well-being of our caregivers. We value diversity, equity, and inclusion in our workplace.
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