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Credentialing Specialist

2 months ago

Oneonta New York, United States A.O. Fox Full time
About the Role

A.O. Fox is seeking a highly organized and detail-oriented Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and integrity of our credentialing database system and related applications.

Key Responsibilities
  • Lead and Coordinate Credentialing Process: Oversee the credentialing and re-credentialing process, ensuring timely and accurate processing of initial and reappointment applications.
  • Verify Practitioner Information: Perform primary source verification on all practitioners, including licensure, board certification, education, internship, residency, fellowship, references, NPDB, Medicare/Medicaid sanctions, and other relevant information.
  • Ensure Compliance: Maintain compliance with accrediting and regulatory agencies, as well as develop and maintain a working knowledge of relevant statues and laws.
  • Communicate Effectively: Communicate regularly with practitioners and clinical chiefs regarding credentialing status, and respond to inquiries from other healthcare organizations.
  • Maintain Confidentiality: Maintain confidentiality of all credentialing information, as noted in the Medical Staff Policy and Procedure Manual.
Requirements
  • Education: High School Diploma or equivalent, required; 2 Year / Associate degree, preferred.
  • Experience: Minimum 1 year administrative support or business office experience, required; Minimum 1 year experience with extensive public contact and customer service, required.
  • Licensure/Certifications: 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.