Credentialing Specialist
3 weeks ago
The Credentialing Specialist at Swope Health Services plays a vital role in ensuring the highest quality provider network.
This position is responsible for developing and implementing centralized credentialing and privileging processes and procedures in accordance with HRSA, Joint Commission, and other grant makers' standards.
The Credentialing Specialist works closely with physicians, mid-levels, licensed independent practitioners, and other licensed or certified practitioners to acquire necessary materials and information for enrollment with commercial insurance plans.
The successful candidate will ensure compliance with HRSA, JCAHO, and other grant makers' or certification standards for credentialing and privileging of various practitioner types.
Maintaining and/or acquiring delegated credentialing as appropriate to benefit Swope Health is also a key responsibility.
The Credentialing Specialist will use credentialing software proficiently and add credentialing information to the HR associate record as necessary.
Coordination with various departments to ensure communication of completed credentialing and privileging requirements is also essential.
The Credentialing Specialist will convene monthly Credentialing Committee meetings, prepare agendas, and record decisions to ensure timely action.
Additionally, the Credentialing Specialist will coordinate with the HR Talent Acquisition team on new hire credentialing and provider enrollment.
Confidentiality regarding all information, results, data, and other sensitive material is essential for this role.
An associate degree in business administration or equivalent experience is required, with a bachelor's degree preferred.
Certified Provider Credentialing Specialist certification is also preferred.
Swope Health Services is a special place that cares for the people who need it most, wherever they are in the community.
We make care visible as part of our promise to battle health inequities and provide high-quality, comprehensive care.
Medical benefits, dental and vision, 401(k) retirement plan with company match, and other benefits are offered to our team members.
We consider all qualified applicants without regard to race, color, creed, religion, gender, national origin, age, marital status, veteran status, or disability.
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