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Scheduled Weekly Hours:
40Work Shift:
Days (United States of America)Primary Function/General Purpose of Position
The Credentialing Specialist facilitates Medical Staff Services Office (MSO) provider application and data collection application processing and Primary Source Verification (PSV) for the organization. Supports the organizations on-boarding and off boarding role follows established standard operating procedures and market specific medical staff bylaws and demonstrates exceptional customer service communication reliability and commitment to quality.
Essential Job Functions
Follows a standardized comprehensive credentialing application and data collection application processing and primary source verification processes that comply with all applicable regulatory standards.
Executes credentialing application and data collection application processing primary source verification for all new applicants and applicants for re-credentialing. Assures applications are correct complete resolves discrepancies in compliance with all applicable regulatory standards.
Assures files and documents are ready for Medical Director review including all Credential Committees and Medical Staff Office(MSO). Works with the credentialing auditors to correct any deficiencies.
Organizes and maintains provider data and applications timely and ensures that quality benchmarks are met with regards to turnaround times accuracy of information and other CVO and regulatory metrics.
Assures that provider database is maintained with new and updated accurate provider information.
Follows all regulatory requirements related to the primary source verification process for medical staff and managed care compliance.
Completes credentialing compliance check points to assure that files are ready for release.
Maintains awareness of The Joint Commission (TJC) National Committee for Quality Assurance (NCQA)Center forMedicare/Medicaid (CMS) and other regulatory compliance guidelines through the organizations CVO provided continuing education.
Demonstrates excellent professional communication skills while interacting with colleagues customer relations and MSO representatives and leadership to collect missing information or resolve issues.
Maintains a strong respect for privacy and confidentiality.
This document is not an exhaustive list of all responsibilities skills duties requirements or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor subject to reasonable accommodation.
Licensing/Certification
Certified Professional Medical Staff Management (CPMSM) or Certified Professional Credentials Specialist (CPCS) by National Association of Medical Staff Services (NAMSS) (preferred)
Education
High School or GED (required)
Bachelors Degree in Business Healthcare or other related field (preferred)
Masters Degree in Business Healthcare or other related field (preferred)
Work Experience
1 year recent experience in medical staff services or CVO setting (preferred)
Training
Credentialstream Credentialing software (preferred)
Language
None
Patient Population
Not applicable to this position
Working Conditions
Periods of high stress and fluctuating workloads may occur.
May have periods of constant interruptions.
Prolonged periods of working alone.
Skills
Medical Staff Credentialing
Data Collection
Data Entry
Healthcare Policies
Confidentiality
Flexibility
Managing Multiple Priorities
Attention to Detail
Accuracy
Teamwork
Conflict resolution
Active listening
Relationship building
Self motivated
Accountability
Mistake Proofing
Autonomy
Managing Deadlines
Communication
Bon Secours is an equal opportunity employer.
What we offer
Benefits may vary based on the market and employment status.
Department:
Medical Staff Affairs - St. Francis - DowntownIt is our policy to abide by all Federal and State laws as well as the requirements of 41 CFR 60-1.4(a) 60-300.5(a) and 60-741.5(a). Accordingly all applicants will receive consideration for employment without regard to race color national origin religion sex sexual orientation gender identity age genetic information or protected veteran status and will not be discriminated against on the basis of disability. If youd like to view a copy of the affirmative action plan or policy statement for Mercy Health Youngstown Ohio or Bon Secours Franklin Virginia; Petersburg Virginia; and Emporia Virginia which are Affirmative Action and Equal Opportunity Employer please email . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process please contact The Talent Acquisition Team at .
Required Experience:
Unclear Seniority
Full-Time