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Full-time 80 hours every 2 weeks | Mon-Fri 8a-5p | Hybrid of in-office (St. Cloud Hospital) and at-home work
JOB SUMMARY:
Responsible for preparing files for medical staff credentialing and privileging for CentraCare within the Clinical Partner Resource Office. The Credentialing Specialist plays a significant key role in assuring physicians and advanced practice providers are qualified to provide quality patient care within CentraCare. The position must accurately and efficiently completes medical staff credentialing, privileging and recredentialing processes in compliance with regulatory requirements, often under short timelines and shifting organizational priorities. In collaboration with physician and advanced practice provider reviewers, incumbent will follow-up on red flag issues in files. Presents files at system-wide Credentialing Committee for discussion and review. Must be highly detail oriented to complete accurate data entry of demographics, education, training, prior hospital affiliations and employment verifications into the credentialing database. Communicate with the practitioners and hospital staff by phone, fax, or email to facilitate the completion or clarification of credentialing and privileging documents. Engages in activities to develop and improve documents, policies and procedures to support day-to-day operations. This role ensures compliance with the Joint Commission, NCQA, Centers for Medicare/Medicaid Services, and other laws or Hospital policies.
Partners with the Manager of Credentialing, Recruitment, Contracting, Department and Medical Staff Leadership, St. Cloud Hospital Vice President of Medical Affairs, Credentials Committee members, members of the Medical Staff, Advanced Practice Providers, and the Medical Staff Office. Supports and implements patient safety and other safety practices as appropriate. Supports and demonstrates Family Centered Care principles when interacting with patients and their families and with co-workers.
EDUCATION & EXPERIENCE:
LICENSES AND CERTIFICATIONS:
QUALIFICATIONS:
CentraCare has made a commitment to diversity in its workforce. All individuals including, but not limited to, individuals with disabilities, are encouraged to apply. CentraCare is an EEO/AA employer.
Full Time
$43k-54k (estimate)
04/24/2024
06/22/2024
centracare.com
MONTICELLO, MN
3,000 - 7,500
1995
NGO/NPO/NFP/Organization/Association
MAT BROWN
$1B - $3B
CentraCare Health owns and operates a chain of non-profit hospitals that offers pediatrics, cancer care, surgical and specialty medical services.
The job skills required for Credentialing Specialist include Patient Care, Health Care, Data Entry, Leadership, Attention to Detail, Collaboration, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist. You can explore the career advancement for a Credentialing Specialist below and select your interested title to get hiring information.
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Quotes from people on Credentialing Specialist job description and responsibilities
A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.
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A credentialing specialist can have certificates that will prove useful to their field.
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Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
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Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.
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Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
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Career tips from people on Credentialing Specialist jobs
Credentialing specialists can often find work with a high school diploma or the equivalent.
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Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.
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While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.
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Make Use Of Advanced Software For Monitoring.
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Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
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Step 3: View the best colleges and universities for Credentialing Specialist.