Privileging Specialist

Responsibilities

• Ensure electronic provider records are being maintained and updated timely, accurately, and regularly to reflect any changes in provider status or credentials.
• Support the team in obtaining additional documentation and verifications as needed, ensuring all records comply with internal and external standards.
• Ensure MSS Department processes are being followed regarding the storing, submission, and information sharing of all obtained, completed, confirmed, and created documentation.
• Ensure current statuses and information is being documented/displayed in the appropriate areas timely.
• Aid in creating abbreviated CVs for privileging and privileging needs as needed.
• Request COI’s for assigned sites in accordance with process.
• Ensure providers are registered with any state Patient Compensation Funds by communicating this information with the risk management department.
• Advise onboarding of any site-specific training courses / orientations, certifications, or education that must be completed for privileges to be approved and track their progress to ensure timely completion as needed.
• Ensure OSS is appropriately assigned reappointments, enrollments, references, and other credentialing tasks; promptly review items personally when necessary, and ensure all tasks are completed in a timely manner.
• Regularly communicate with assigned facilities' Medical Staff Professionals, ensuring timely responses to all queries; facilitate the resolution of outstanding items as requested by collaborating with internal and external stakeholders.
• Maintain up-to-date knowledge of site-specific details, including meeting dates, workflows, and unique procedural nuances, and ensure all related systems and documentation are updated appropriately when changes occur.
• Perform regular follow-up, as necessary, via telephone, email, and other available and necessary means of communication with both providers, medical staff offices, and other agencies.
• Complete / facilitate completion, from start to finish, all steps necessary to submit complete and accurate pre-applications, initial applications, reappointments, add/change requests, and enrollment applications; including but not limited to supporting and/or supplemental documentation, current governmental health plan logins / connection requests are being completed, adding state licenses to NPPES, etc.
• Participate in education sessions specific to corporate needs or job duties, whether locally or remotely, as needed.
• Perform other job-related duties as required, adapting to new challenges and responsibilities as they arise.
• Assist in audits and other administrative tasks assigned by management.

Qualifications

• A high school diploma/GED.
• At least 2-3+ years of professional experience in a similar role.
• Ability to maintain a high level of confidentiality.
• Strong organizational skills.
• Proficiency in Microsoft Office, particularly Excel and Word.
• Professional written and verbal communication and interpersonal skills required.
• Ability to work efficiently in a remote environment; highly engaged and proactive, results-driven attitude.