Credentialing Specialist I | Med Staff | Days

Responsibilities

• Conducts primary source verification of provider applications with multiple entities as outlined in the Medical Staff Services Credentialing Policy and required by the applicable regulatory agencies and internal governance documents in a timely and efficient manner.
• Maintains the Medical Staff Services database.
• Responds to questions regarding expiring credentials, uploads renewed credentials into the database, maintains the database auto-alert system as required, and ensures data integrity.
• Maintains a professional demeanor as a representative of the department and the YRMC organization.
• Assists providers as needed, in person, through email, or responding to calls in a timely fashion.
• Maintains positive professional communication, both written and verbal, with the Medical Staff, Administration, and all other YRMC staff.
• Processes pre-checks of potential candidates as outlined in the Medical Staff Services Credentialing Policy.
• Works collaboratively with Provider Services to facilitate the pre-check process.
• Maintains records of pre-check data.
• Provides administrative coverage and support as needed include routine reports, special projects, department meetings and accounting reconciliation.
• Supports the Credentialing Specialist II to facilitate the reappointment and initial appointment process.
• Collaborates with all team members to ensure accuracy in file completion.
• Assists Director in assuring compliance with bylaws, policies, procedures, and compliance guidelines; participates and supports quality assurance, performance improvement programs and processes.
• Assists Director in maintaining budgetary expenses including purchases supplies, equipment and capital items.
• Processes check requests for reimbursements, maintains adequate level of supplies in a cost-effective manner.

Qualifications

• High School Diploma or GED
• One year of general office experience
• One to three years of experience in Hospital Credentialing/privileging or Provider Enrollment Credentialing preferred
• Proficiency with Microsoft Office: Word, Excel, Power Point