Credentialing Specialist (onsite) (Summit)

Description :

• The Credentialing Specialist is responsible for managing the credentialing and re-credentialing process for physicians and allied health practitioners. This includes verifying qualifications, maintaining compliance with regulatory standards, updating provider data, and coordinating with internal and external stakeholders.

Verification of Credentials Confirm that healthcare providers (e.g., physicians, nurses, therapists) have valid and current licenses, certifications, education, and training. Verify board certifications, malpractice history, and work experience.

Essential Functions :

• Enforce regulatory compliance and quality assurance Prepare and maintain reports of credentialing activities such as accreditation, membership or facility privileges Ensure that all information meets legal, federal and state guidelines when processing applications Responsible for carrying out various credentialing processes in relation to physicians and allied health practitioners Process applications for initials applicants as well as reappointments (approximately 125-200 quarterly) Collect and process significant amounts of verification and accreditation information Maintain and update accurate information in the Echo database (includes education, training, experience, licensure) Prepare material for Credentials Committee meeting, MEC as well as Board of Trustees meeting Sets up and maintains provider information in Echo Maintains confidentiality of provider information Ensure compliance with the Bylaws at each location as it pertains to the credentialing process Schedule, and on occasion attend and take minutes for site based medical staff department meetings Process and collect dues for the site based medical staff Compiles and maintains current and accurate data for all providers Sets up and maintains provider information in online credentialing database Tracks license and certification expirations for all providers Maintains confidentiality of provider information All other duties as assigned