Credentialing Specialist

4 weeks ago

Reisterstown, Maryland, United States LADGOV CORPORATION Full time
Job Title: Credentialing Coordinator

LADGOV CORPORATION is seeking a highly skilled Credentialing Coordinator to join our team. As a Credentialing Coordinator, you will be responsible for organizing, maintaining, and verifying all aspects of the credentialing process for healthcare practitioners in a health care-related facility.

Duties and Responsibilities:
  • Responsible for ensuring that all providers' military medical credentialing and privileging is initiated, maintained, and transferred as required, throughout the term of their military service.
  • Responsible for collecting all required legal documentation for each provider to be credentialed, including medical diplomas, DEA licenses, state licenses, National Practitioner Database records, malpractice documentation, certifications, post-graduate training records, and references in accordance with HIPAA guidelines.
  • Validate the accuracy and completeness of all records received and ensure all new initial provider applications are complete.
  • Maintain custody of all credentialing materials via the Centralized Credentials Quality Assurance System (CCQAS).
  • Upload records to build and maintain provider profiles, including demographic information, educational documentation, continuing education credits, intra-facility credentialing transfer briefs (ICTBs), custody transfers, and adverse action reports.
  • Track document expiration status in CCQAS and ensure records are updated in a timely manner.
  • Attend Centralized Credentialing and Privileging Board (CCPB) meetings and present credentialing packets to the Board for approval.
  • Build ICTBs as required for all providers attending Annual Training or mobilizing outside of Maryland.
  • Validate document currency for all records in the ICTBs prior to submission.
  • Follow-up on all ICTB submissions to ensure their completion and transfer to the gaining facility.
Requirements:
  • Shall have a minimum of two years practical experience in provider credentialing and privileging.
  • Experience and knowledge of Army and National Guard Bureau regulations and policies relating to provider credentialing and privileging, and utilizing the Defense Health Agency's Centralized Credentials Quality Assurance System (CCQAS) are preferred.

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