Credentialing Specialist

6 days ago

Oneonta, New York, United States A.O. Fox Full time
Overview

Bassett Healthcare Network is seeking a skilled Credentialing Specialist to join our team. As a key member of our Medical Staff Affairs department, you will play a critical role in ensuring the accuracy and integrity of our credentialing processes.

Responsibilities
  • Lead and coordinate the credentialing and re-credentialing process, ensuring timely and accurate completion of applications.
  • Process initial and reappointment applications with 95-100% accuracy, as observed by the manager.
  • Enter practitioner information into the credentialing database with 95-100% accuracy, as observed by the manager.
  • Perform primary source verification on all practitioners, including sending letters to verify licensure, board certification, education, and other credentials.
  • Identify red flags and items requiring further review, and bring them to the attention of the MSA Manager, Clinical Chief, and Medical Staff President.
  • Ensure compliance with accrediting and regulatory agencies, and develop a working knowledge of relevant statues and laws.
  • Process requests for privileges, ensuring compliance with clinical privilege descriptions.
  • Maintain confidentiality of all credentialing information, as noted in the Medical Staff Policy and Procedure Manual.
  • Assemble credentialing packets for presentation to the Credentials Committee of the Medical Staff.
  • Serve as a resource to practitioners and clinical chiefs with issues regarding licensing, board certifications, and other credentialing matters.
  • Communicate regularly with practitioners and Clinical Chiefs regarding credentialing status.
  • Conduct regular internal audits of credentialing files to ensure compliance with regulatory agencies, Medical Staff Policies and Procedures, and Bylaws.
  • Responsible for the accuracy and integrity of the credentialing database system and related applications.
  • Maintain an accurate and up-to-date record of internal and external CMEs in the providers' file.
  • Respond to data requests and coordinate all new provider orientation schedules after approval by the Board of Trustees.
  • Respond to inquiries from other healthcare organizations and interfaces with internal and external customers on day-to-day credentialing and privileging issues.
  • Respond weekly to affiliation/employment verification requests for all APCs and Medical Staff.
  • Work collaboratively with the affiliate hospital Medical Staff Offices and attend meetings as assigned, preparing minutes as requested.
  • Presents a positive image of Bassett Healthcare Network through professional appearance and behavior.
  • Communicates effectively to ensure vital operational information is shared among co-workers.
  • Exercises independent judgment within the scope of responsibilities and absence of direct authority.
  • Attends all required hospital education programs.
  • Performs other duties as requested and observed by manager.
Qualifications
  • High School Diploma or equivalent, required.
  • 2 Year / Associate degree, preferred.
  • Minimum 1 year administrative support or business office experience, required.
  • Minimum 1 year experience with extensive public contact and customer service, required.
  • CPCS Certified Provider Credentialing Specialist, preferred.
Skills
  • Organizing/Categorizing records.
  • Communication.
  • Attention to Detail.
  • Analysis & Evaluation.
  • Computer Skills.
  • Maintain Confidentiality.
  • Reading/Writing/Comprehension.
  • Build Relationships.
  • Time Management.
  • Self-Motivated.
Physical Requirements

Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are met.

Occasional lifting, pulling, pushing, reaching, standing, stooping, walking.

Constant typing/clerical/dexterity, grasping, hearing, repetitive motion, seeing/monitor/computer use, talking, visual acuity.

Travel

Occasional Travel - The job may require travel from time-to-time, but not on a regular basis.

Total Rewards

Bassett Healthcare Network's commitment to our employees includes benefit programs carefully designed with the needs and values of all our employees in mind.

Many of the benefits we offer are paid fully or in large part by Bassett.

Our generous benefits offerings include:

  • Paid time off, including company holidays, vacation, and sick time.
  • Medical, dental and vision insurance.
  • Life insurance and disability protection.
  • Retirement benefits including an employer match.
  • And more.

Specific benefit offerings may vary by location and/or position.

Pay Transparency Statement

Salary is based on a variety of factors, including, but not limited to, qualifications, experience, education, licenses, specialty, training, and fair market evaluation based on industry standards.

The above compensation range represents a good faith belief of the compensation range by Bassett Healthcare Network, and its entities and affiliates, at the time of this posting or advertisement.

Min:

USD $20.29/Hr.

Max:

USD $30.44/Hr.

EEO Statement

We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.

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