The Credentialing Specialist leads and maintains the provider credentialing and re-credentialing process. This includes managing provider data, tracking license expirations, and ensuring compliance with Medical Staff Bylaws.
Requirements summary
Candidates must have a high school diploma or GED and be BLS certified or obtain certification within 30 days of hire. Proficiency in Microsoft Office and strong organizational skills are required.
high schoolprofessional certificateAttention To DetailWritten CommunicationVerbal CommunicationData AnalysisRegulatory ComplianceMicrosoft OfficeResearchData ManagementCredentialingRe-credentialing
Job description
Townsen Memorial is hiring a Full-Time Credentialing Specialist at our Humble Location! The Credentialing Specialist is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process. ESSENTIAL FUNCTIONS:
Compiles and maintains current and accurate data for all providers
Completes provider credentialing and re-credentialing applications monitors applications and follows-up as needed
Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
Maintains corporate provider contract files
Maintains knowledge of current credentialing processes for al providers
Sets up and maintains provider information in online credentialing databases and systems
Tracks licenses and certification expirations for all providers to ensure timely renewals
Processes applications for appointment and reappointment of privileges to the facility
Maintains facility appointment files, and information in credentialing database
Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up
Ensures compliance with Medical Staff Bylaws, rules and regulations, policy and procedures
Assists with credentialing audits
Performs other related duties as assigned KNOWLEDGE, SKILLS, AND ABILITIES:
Knowledge and understanding of credentialing process
Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources
Ability to organize and prioritize work and manage multiple priorities
Excellent attention to detail, verbal and written communication skills including letters, memos, and emails
Ability to maintain positive, constructive, collaborative, cooperative professional friendly and respectful working relationship with coworkers and supervisor
Ability to research and analyze data
Ability to work independently with minimal supervision
Ability to establish and maintain effective working relationships with providers, management, staff and contacts outside the organization EDUCATION AND EXPERIENCE:
High school diploma or GED
Basic Life Support (BLS) certified or must be obtained within thirty (30) days of hire Townsen Memorial Hospital is an accredited network of facilities with an emphasis on emergency care, outpatient surgery, and diagnostics and imaging. Our core mission is to provide compassionate, evidence-based patient care to those we serve. At Townsen Memorial we encompass diversity, dignity, and inclusiveness as a reflection of our core values. Townsen Memorial is committed to driving cutting edge healthcare to our patients, our communities and each other.
