Credentialing Specialist

3 weeks ago

Lincoln Nebraska, United States CommonSpirit Health Full time
Overview:
This Part Time position is onsite at St. Elizabeth in Lincoln, NE
LOCAL CANDIDATES ONLY

Job Summary / Purpose

Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process. Facilitates all aspects of CHI Health System credentialing and CHI Health Credentialing Verification Organization.  This includes initial appointment, reappointment, expirables process, as well as clinical privileging for Medical Staff and Advanced Practice Clinicians. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. Responsible for the accuracy and integrity of the credentialing database system and related applications.

 

CHI Health strives to care for you the way you care for your patients. 

We understand you have personal responsibilities outside of your profession and also care about your well-being. 

 

With you in mind, we offer the following benefits to support your work/life balance:

 

Health/Dental/Vision Insurance 

Direct Primary Plan (No copay, no deductible, and access to CHI Health provider 24/7)

Premium Access to our Family Care Program supporting your needs for childcare, pet care, and/or adult dependent care

Voluntary Protection: Group Accident, Critical Illness, and Identity Theft 

Employee Assistance Program (EAP) for you and your family

Paid Time Off (PTO) 

Tuition Assistance for career growth and development

Matching 401(k) and 457(b) Retirement Programs

Adoption Assistance

Wellness Programs

Flexible spending accounts

 

  

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities:

Essential Key Job Responsibilities

Reviews practitioner applications and accompanying documents, ensuring applicant eligibility.

Conducts thorough background investigation, research and primary source verification of all components of the application file.

Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.

Prepares credentials file for completion and forwards all information to the applicable entities ensuring file completion within time periods specified.

Processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.

Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.

Assists with managed care delegated credentialing audits.

Utilizes the Medical Staff credentialing database, optimizing efficiency, and performs query, report and document generation.

Monitors the initial, reappointment and expirables process for all medical staff, APC staff,  and delegated

Qualifications:
Qualifications

 

High School diploma or equivalent required

Ability to communicate effectively, both orally and in writing.

Program planning and implementation skills.

Knowledge of related accreditation and certification requirements.

Knowledge of medical credentialing and privileging procedures and standards.

Ability to analyze, interpret and draw inferences from research findings, and prepare reports.

Working knowledge of clinical and/or hospital operations and procedures.

Informational research skills.

Ability to use independent judgment to manage and impart confidential information.

Database management skills including querying, reporting, and document generation.

Ability to make administrative/procedural decisions and judgments.

 

PREFERRED Qualifications

 

Knowledge of related accreditation and certification requirements.

Knowledge of medical credentialing and privileging procedures and standards.

Working knowledge of clinical and/or hospital operations and procedures.

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