CVO Credentialing Coordinator
Share
Job Location:
Woburn, MA - USA
Monthly Salary:
$ 28 - 37
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
When you join the growing BILH team youre not just taking a job youre making a difference in peoples lives.
The CVO Credentialing Specialist is accountable for the independent management analysis and primary source verification of credentialing applications for initial appointment and reappointment including associated clinical privileges in accordance with BILH CVO policies regulatory standards and accreditation requirements.This role requires the exercise of professional judgment in evaluating credentialing data identifying potential compliance risks and ensuring the accuracy completeness and audit-readiness of credentialing files. The Credentialing Specialist supports timely provider onboarding and ongoing compliance by maintaining high standards of data integrity documentation and communication.
The CVO Credentialing Specialist exemplifies a culture of excellence effective communication collaboration and customer service while working with CVO leadership and staff providers Medical Staff Offices and clinical and administrative leaders across the BILH system.
The position routinely handles information that is complex sensitive multidisciplinary and confidential and requires a strong working knowledge of medical staff operations regulatory requirements and the unique cultures of affiliated institutions. The role contributes to the advancement of a standardized efficient and compliant system-wide credentialing operation.
Job Description:
Essential Duties & Responsibilities:
Independently manages credentialing applications for initial appointment and reappointment including application intake validation verification and ongoing status management.
Conducts primary source verification activities and performs detailed analysis of application and verification data to ensure accuracy completeness and compliance with regulatory accreditation and organizational requirements.
Evaluates verification results to identify red flag adverse or inconsistent information and escalates findings to CVO leadership in accordance with established policies exercising professional judgment to support appropriate review and resolution.
Monitors and tracks time-sensitive credentialing elements including but not limited to state licensure DEA registration professional liability insurance and specialty board certification to ensure continuous compliance.
Maintains complete accurate and audit-ready credentialing files in paper and/or electronic format ensuring documentation meets internal standards and external audit requirements.
Ensures the integrity accuracy and timeliness of credentialing data entered into credentialing databases and associated systems.
Prepares credentialing files for internal review peer audit committee consideration and submission to assigned hospitals ensuring adherence to established turnaround times and quality standards.
Participates in peer-to-peer credential file audits and quality review activities as assigned contributing to continuous process improvement and consistency across the CVO.
Communicates effectively with supervisors and team leads regarding application status barriers and resolution needs to support workflow efficiency and service level expectations.
Maintains a working knowledge of applicable accreditation regulatory and statutory requirements (including but not limited to TJC and NCQA standards) and applies this knowledge to daily credentialing activities.
Participates in special projects workgroups and system-wide initiatives as assigned supporting standardization efficiency and quality improvement within the CVO.
Minimum Qualifications:
Education: High School Diploma or higher
Licensure Certification & Registration: CPCP or CPMSM Certified is preferred OR Willingness to achieve CPCS certification.
Experience: At least two (2) years of experience in a centralized credentialing and verification office (CVO) or Medical Staff Services in an acute healthcare setting including experience in processing initial and/or reappointment applications is preferred.
Skills Knowledge & Abilities: Knowledge of credentialing software and associated applications strongly preferred. Excellent interpersonal and communication skills Ability to work under minimal supervision and to adapt quickly to changes within the environment.
Pay Range:
$28.72 - $37.94The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors that may include seniority education training relevant experience relevant certifications geographyof work location job responsibilities or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials call pay premium pay overtime pay and other additional pay practices as applicable to the position and in accordance with the law.
As a health care organization we have a responsibility to do everything in our power to care for and protect our patients our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.
More than 35000 people working together. Nurses doctors technicians therapists researchers teachers and more making a difference in patients lives. Your skill and compassion can make us even stronger.
Equal Opportunity Employer/Veterans/Disabled
Required Experience:
IC
Key Skills
- Corporate Risk Management
- Electronics
- Infection Control
- Bakery
- ELV
- Accident Investigation
About Company
Easily find the care you need when you need it. Find a doctor, schedule an appointment and put your health first. With 13 locations, our expert health care providers are nearby and ready to help.
