Credentialing Specialist
Credentialing Specialist
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Job Description
Company Intro
At American Vision Partners (AVP) we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems operational infrastructure and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center Southwestern Eye Center Retinal Consultants of Arizona M&M Eye Institute Abrams Eye Institute Southwest Eye Institute Aiello Eye Institute Moretsky Cassidy Vision Correction Wellish Vision Institute West Texas Eye Associates and Vantage Eye Center. We are focused on building the nations largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona New Mexico Nevada California and Texas including 25 ambulatory surgical centers.
At AVP we value teamwork providing exceptional experiences continuous improvement financial strength and hard work. We are committed to providing best-in-class patient care pioneering research and technology and most importantly rewarding and recognizing our employees!
Overview
The Credentialing Specialist is responsible for ensuring that healthcare professionals such as doctors nurses and other allied health professionals are properly credentialed to work within a healthcare facility or organization. This role involves verifying the qualifications licenses and credentials of healthcare providers to meet regulatory and accreditation requirements ensuring compliance with industry standards
Responsibilities
- Assists with initial and reappointment of privileges for medical staff and allied healthcare professionals at AVP ambulatory surgery centers and clinics.
- Performs primary source verification of all components of the providers and facilities.
- Review and analyze completed applications for completeness and accuracy.
- Prepares provider files for Peer Review and MEC approvals.
- Input and maintain credentialing information in credentialing software or database
- Ensures compliance with applicable laws and regulations of AAAHC state and federal government agencies.
- Serve as the primary point of contact for healthcare providers regarding credentialing inquiries.
- Assists with maintaining an accurate credentialing database.
- Maintains accurate document filing in appropriate provider and facility folders.
- Assists with state and other agency surveys.
- Assists with managing initial and annual provider training.
- Recommend improvements to credentialing processes to increase efficiency and compliance. Provide regular reports to management on credentialing status and any issues or delays.
- Performs miscellaneous job-related duties as assigned.
Qualifications
- High School Diploma or equivalent
- At least 2 3 years experience in Credentialing. Previous experience in healthcare credentialing or medical staff services
- Proficiency in Microsoft Office Suite (Word Excel Outlook) and credentialing software
- Strong organizational skills and ability to pay attention to detail
- Strong understanding of healthcare accreditation standards regulatory compliance and state/federal requirements.
- Proficiency in Microsoft Office Suite (Word Excel Outlook) and credentialing software.
- Strong organizational and time management abilities.
- Strong communication and interpersonal skills.
- Ability to work independently and collaboratively within a team
- Manage multiple tasks simultaneously
- Strong knowledge of industry regulations such as the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC) standards and Accreditation Association for Ambulatory Health care (AAAHC)
Work Environment:
- Office-based role with occasional remote work opportunities depending on organizational policy.
- May require occasional overtime or flexible hours to meet deadlines.
Benefits & Perks
Your health happiness and your future matters! At AVP we offer everything from medical and dental insurance significant eye care discounts child care assistance pet insurance continuing education funds 401(k) paid holidays PTO Sick Time opportunity for growth and much more!
Required Experience:
Unclear Seniority
Employment Type
Full-Time
