Credentialing Specialist

Job Duties

• Verifies all licensure at initial, reappointment, and upon expiration of license.
• Obtains copy of licensure as necessary.
• Reviews assigned initial and reappointment applications for medical staff and allied health staff to ensure all sections are complete and documentation is included.
• Updates database information, i.e., license and insurance renewals, address changes, status changes, Board approval, date, etc., within two to three days of receipt/change of information.
• Filings credentialing documents and updated licensure and verifications of licensure upon receipt.
• Assists with recruiting activities including moving, new employed provider paperwork and other related activity to bring on a new provider.
• Greets office visitors in a professional and helpful manner.

Education and Experience

• High School diploma or equivalent
• 3 years business experience at the level of administrative assistant

Knowledge and Skills

• Knowledge of credentialing principles, including the Medical Staff Standards of JCAHO and Credentialing Standards of CMS.
• Knowledge of medical and postgraduate education.
• Knowledge of various computer programs including Microsoft Word and the Internet.
• Computer skills and dexterity required for data entry and retrieval of patient information.
• Proficient with Windows-style applications and keyboard.
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.

Physical and Environmental Demands

• Mechanical lifting devices (carts, dollies, etc.) or team lifts should be utilized.
• Sit for prolonged periods of time.
• Work a flexible work schedule (e.g. 24/7, weekend, holiday, on call availability).

Compliance

• Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
• Complies with the Ochsner Health System Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.