Credentialling and Privileging specialist

Found in: Resume Library US A2 - 1 week ago

Nashville Tennessee, United States Nashville General Hospital Full time


Credentialing and Privileging Specialist at Nashville General Hospital

Educational Requirements:
Three years of privileging experience required.

Certification & Licensure:
Certification by NAMSS is desirable, but not required.

Experience:

Minimum of 3-5 years experience in privileging of medical staff, allied and medical staff and providing support of medical staff Committees.

Job Duties:
1. Compiles and maintains current and accurate data for all providers.
2. Completes provider credentialing and re-credentialing applications; monitors applications and follows up as needed, either manually or using software.
3. Will be responsible for the credentialing of fellows and the setup of other clinical students that rotate through Nashville General Hospital
4. Develop and maintain and good rapport with the Chief of service, members of the Medical Staff, and affiliates
5. Responsible for FPPE and OPPE data in relation to credentialing requirements
6. Maintains current copies of state licenses, DEA certificates, malpractice coverage, board certifications, and other required credentialing documents for all providers.
7. Sets up and maintain provider information in online credentialing databases and systems.
8. Maintains appointment files and information in the credentialing database.
9. Provide privileging verifications.
10. Supports medical staff committees by attending and hosting meetings, taking minutes, and scheduling activities of the committees.
11. Perform NPDB enrollments and queries
12. Responsible for participation and coordination of events, meetings, and other activities hosted by the Medical Staff Services
13. Will serve as a backup for payer enrollment task if needed
14. Maintains confidentiality of provider information.
15. Answer the telephone and take accurate messages.

Skills Required:
1. Expert knowledge and understanding of the credentialing process.
2. Ability to organize and prioritize work and manage multiple priorities.
3. Excellent verbal and written communication skills.
4. Excellent attention to detail.
5. Ability to research and analyze data.
6. Must be able to work independently, with minimal supervision.
7. Ability to establish and maintain effective and productive working relationships with providers, management, staff, and contacts within and outside the organization.
8. Must be proficient in the use of Microsoft Office applications

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