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Job Type:
RegularScheduled Hours:
40Work Shift:
Day (United States of America)The CVO Credentialing Specialist shall be accountable for performing all the duties related to the sending, receiving, processing, and primary source verifying applications for initial and reappointment and their related clinical privileges.Job Description:
Essential Duties & Responsibilities including but not limited to:
In accordance with established CVO policies and procedures for assigned hospitals, the CVO Credentialing Specialist shall include the following:
Application management and verification activities, preliminary analysis of application and verification information, and analyzing verification information, to include identifying red flag and/or adverse information and notifying CVO leadership in accordance with CVO policies.
Monitoring of expiring information such as, but not limited to, federal and state DEA, state professional license(s), professional liability insurance, and specialty board certification status.
Maintain and update credentials file(s) (paper and/or electronic as applicable), timely, accurate, and complete database entries, and maintenance of electronic files, as required.
Appropriately and timely communicate with assigned medical staff offices.
Timely and accurately prepare credential files for audit and submission to assigned hospitals.
Compliance with standard turn-a-round times.
Maintain a working knowledge of relevant regulatory standards (i.e., TJC and NCQA), state and federal requirements, and applicable Medical Staff Bylaws.
Assist with the development and implementation of credentialing and recredentialing workflows to ensure efficient and effective alignment of processes and assists in the development or revision of credentialing related forms.
Participation in special project teams as assigned.
Takes a proactive role in monitoring and assisting in improving team productivity and continually strives to achieve individual, team and departmental goals.
Minimum Qualifications:
Education:
High School Diploma.
Licensure, Certification & Registration:
Certified Professional in Medical Staff Management (CPMSM)
OR
Certified Provider Credentialing Specialist (CPCS) preferred
OR
Achievement of certification (CPMSM/CPCS) within 24 months of becoming eligible.
Experience:
At least two (2) years of experience in a CVO or Medical Staff Services in an acute healthcare setting, including credentialing and privileging is preferred.
Skills, Knowledge & Abilities:
Knowledge of credentialing software and associated applications strongly preferred.
Excellent interpersonal and communication skills
Ability to work under minimal supervision and to adapt quickly to changes within the environment.
FLSA Status:
Non-ExemptFull Time
$46k-58k (estimate)
10/25/2023
04/24/2024
The job skills required for Credentialing Specialist include Customer Service, Health Care, Communication Skills, Leadership, 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.
If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
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.
03/14/2022: Des Moines, IA
A credentialing specialist can have certificates that will prove useful to their field.
02/01/2022: Newark, NJ
Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
02/21/2022: Evansville, IN
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.
02/01/2022: Las Cruces, NM
Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
01/18/2022: Pueblo, CO
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Credentialing Specialist jobs
Credentialing specialists can often find work with a high school diploma or the equivalent.
01/25/2022: Kingsport, TN
Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.
03/01/2022: Parkersburg, WV
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.
12/25/2021: Little Rock, AR
Make Use Of Advanced Software For Monitoring.
01/18/2022: New London, CT
Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
01/31/2022: Portsmouth, OH
Step 3: View the best colleges and universities for Credentialing Specialist.