Credentialing Specialist
Client Summary :
The nation's largest municipal health care delivery system in the United States dedicated to providing the highest quality health care services to all New Yorkers with compassion, dignity and respect, and regardless of immigration status or ability to pay.
Job Description :
- The Credentialing Specialist is responsible for facilitating all aspects of provider credentialing, including initial appointment, reappointment, credential audits, as well as clinical privileging for Medical Staff, Allied Health Professionals, and all other providers as outlined in the corporate policy and procedures, or hospital bylaws.
- Utilize MDStaff credentialing software application to perform and monitor all credentialing / background checks, while maintaining accuracy and data integrity.
Responsible for 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.
This is not a remote job and all work is performed on site..
Notes from the Supplier :
- Medical coding in an acute care setting; must possess proficient computer skills (, MS Word, Excel, ICD CM, CPT , Encoder);
- knowledge of coding guidelines, payor guidelines, federal billing guidelines; knowledge of anatomy, physiology & disease processes;
ability to research coding related issues; competence in coder training; must have CCS and knowledgeable with M / HDS coding application.
Inpatient and ED experience.
Additional Remarks :
- Healthcare Field Experience- Required
- Bachelors Degree- Required
- Credentialing : Responsible for all aspects of provider credentialing and re-credentialing.
- License Renewals : Ensures that physician licenses are renewed prior to expiration.
- Primary Source Verification : Completes primary source verification for new and existing providers to ensure due diligence.
- Records Management : Maintains assigned physician files, updating each item / action as processed.
- Utilizes database status / alert and other report functions, software tools and links to scanned documentation.
- Ensures that information is current and accurate.
- Credentialing Standards : maintains consistency in database entry to ensure accurate and consistent processes.
- Back-up Coverage : provide credentialing back-up for other members of the credentialing group.
Contract Length : weeks
weeks
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