Credentialing Specialist

Found in: Resume Library US A2 - 7 days ago


Phoenix Arizona, United States NATIVE HEALTH Full time
Job Description

The Credentialing Specialist is responsible for all aspects of the initial credentialing, re-credentialing, and privileging processes for all licensed/certified providers and staff who provide patient care at Native Health. This position maintains up-to-date data for each provider in credentialing databases and online systems and ensures timely renewal of licenses and certifications.  In addition, this position performs a variety of administrative support functions and activities for the Administrative Department.

KEY ACCOUNTABILITIES:

Manages the initial credentialing and privileging process for all licensed or certified health practitioners including other clinical staff, contractors, volunteers, and students.

Manages the re-credentialing and re-appointment of privileges process for all licensed or certified health practitioners including staff, contractors, volunteers, and students.

Maintains complete files related to credentialing and health plan contracting ensuring privacy and confidentiality are safeguarded.

Tracks credentialing and health plan contract data and completes follow up as deemed necessary.

Maintains Employee Health Records

Assists in ensuring the organization remains in good standing and meets all reaccreditation requirements.

Supports the organization as needed.


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