Credentialing Specialist

Forest Park, GA
Full Time
Experienced

Essential Functions and Job Responsibilities:

Individual will be responsible for managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health). This includes reviewing applications for completion, verification of state licensure, collecting information contained in the national physician data bank, collecting information from the Health Care Integrity and Protection Databank, collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals.

Job duties will specifically also include:

· Providing direct supervision to the support staff in administering all aspects of processing applications.

· Implementing USARC policies and standards to ensure that credentialing operations are in compliance.

· Working with applicants and USARC staff to support and enhance credentialing functions.

· Completing verifications and ensuring that the organization and staff are in accordance with USARC directives and industry trends and standard credentialing procedures.

· Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results.

· Generating and mailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing.

· Entering data in the CCQAS as directed.


Requirements

Minimum Requirements:

·Bachelor's Degree in a Healthcare, Quality Assurance, or related field and 3 years of experience, including experience with medical credentialing. An equivalent combination of education and experience may be considered in lieu of the degree.

·Good communication and interpersonal skills.

· Organization skills and ability to be detail-oriented and accurate in work produced.

·Skills with MS Office, i.e. Word, Excel, and/or PowerPoint.

· US Citizenship and ability to obtain a favorable National Agency Check with Inquiries (NACI) or Interim Secret clearance.

Additional Desired Qualifications:

· Experience in the DOD credentials process.

· Experience with CCQAS.

· Leadership experience/ability/aptitude.

· Certification from National Association of Medical Staff Services (NAMSS) as a Certified Provider Credentialing Specialist (CPCS)

In addition, U.S Citizenship is required. Applicants selected will be subject to a government security investigation and must meet eligibility requirements for access to classified information and be able to obtain a government-granted security clearance. Individuals may also be subject to a background investigation to include but not limited to criminal history, employment and education verification, drug, testing, and creditworthiness.

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