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Credentialing Specialist II
2 months ago
Chi is recognized as a leading institution in healthcare, dedicated to research and clinical excellence. Our commitment to innovation has resulted in groundbreaking advancements in various medical fields. We focus on enhancing patient care through a state-of-the-art facility designed with the human experience in mind, ensuring safety and comfort for all stakeholders. Our partnerships with renowned medical organizations enable us to provide a comprehensive network of care that is unparalleled.
Key Responsibilities
The Credentialing Coordinator II will oversee credentialing functions at the division level, which includes data management and maintenance of physician databases. This role serves as a crucial link between healthcare providers and facilities throughout the credentialing journey. The coordinator will be responsible for understanding and applying the requirements set forth by State and Federal Regulatory Agencies, ensuring compliance with accreditation standards and other essential regulations that impact the healthcare sector.
Core Duties
- Initiates and manages the collection of primary source information necessary for credentialing at the division level. Ensures verification and maintenance of confidential data required for both initial appointments and reappointments. Processes applications in accordance with established legal and regulatory standards.
- Conducts detailed evaluations of all primary source documentation to assess qualifications and competencies. Ensures that appropriate education and training documentation supports requested clinical privileges. Identifies potential quality of care concerns and escalates issues as needed.
- Facilitates the review and assessment of applications, serving as the main point of contact for practitioners during the credentialing process. Provides guidance and clear communication regarding requirements.
- Maintains an accurate and secure database of physician and allied health professional information, demonstrating proficiency with credentialing platforms. Acts as a database expert and trainer as necessary.
- Mentors junior team members, actively contributing to the development and implementation of best practices.
- Appropriately escalates concerns regarding credentialing documentation and verification timelines, ensuring timely communication with facilities.
- Supports standardization efforts within the system and division, participating in the development of best practices.
- Monitors and manages all required expirables.
- Performs additional duties as assigned, ensuring effectiveness and timeliness.
Required Education and Experience:
- A minimum of ten (10) years in medical staff services or five (5) years with relevant certification (CPCS or PMSVSC).
- An Associate's degree is preferred.
- Experience with credentialing databases, preferably MSOW or Cactus.
- Proficiency in Microsoft Office and/or Google Workspace.
- Strong written and verbal communication skills.
- Excellent attention to detail and data entry skills; ability to prioritize effectively.
- Capability to work remotely while maintaining confidentiality and meeting deadlines.
- Ability to synthesize and analyze data, performing tasks with a suitable work pace.
- Competence in managing complex tasks and maintaining positive relationships with colleagues and clients.
- Sound judgment and decision-making abilities based on relevant information.
- Willingness to take responsibility for daily workload management.
The responsibilities outlined above are intended to convey the general nature of the work performed in this position. They are not intended to be an exhaustive list of all duties that may be assigned.
