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Credentialing specialist
ProSphere Forest, GA
$40k-50k (estimate)
Full Time | Business Services 1 Month Ago
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ProSphere is Hiring a Credentialing specialist Near Forest, GA

Overview

Cognito Systems, a Planned Systems International (PSI) joint venture, is seeking a skilled Credentialing Specialist. The purpose of this overall project is to provide centralized credentialing and privileging services and support to the United States Army Reserve (USAR) Command with initial entry credentialing, maintenance of credentialing and privileging, and support the Centralized Credentials Privileging Board’s review of completed credentials and privileging files.

Essential Functions and Job Responsibilities

Individuals 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 :

  • Implementing USAR policies and standards to ensure that credentialing operations are complying.
  • Working with applicants and USAR staff to support and enhance credentialing functions.
  • Completing verifications and ensuring that the organization and staff are in accordance with USAR 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 emailing notification letters of credentialing results to applicants and / or responding to questions from applicants regarding status of credentialing.
  • Data entry into CCQAS as the official system of record.
  • Prepare and maintain reports of employees based on accreditation, education, facility privileges, experience, membership and licensure, ensuring all employee information meets federal, state and local guidelines.
  • Maintain regular written and verbal correspondence with agencies, hospitals, malpractice carriers and medical review boards
  • Candidate may manage or supervise administrative aspects of the Contractor’s operations.

Minimum Requirements

  • Two years of experience in performing the following functions : conduct administrative and record keeping aspects of the operation of engineering or technical projects / programs;
  • apply knowledge of office management, methods and procedures in producing and maintaining documentation, correspondence, records or directives;
  • Knowledgeable of requirements for verifying doctors' or other types of practitioners' credentials, processing the information and maintaining information data files.
  • Have knowledge, and the maintain awareness, of current American Accreditation Healthcare Commission standards.
  • Proficient with Microsoft Office software, to include, but not limited to Word, PowerPoint, Excel, Outlook, etc.
  • Excellent verbal and written communication skills, including excellent customer relationship skill sets.

Desired Qualifications

  • Associate's degree or higher
  • Experience in Quality Assurance preferred.
  • Experience in the DOD credentials process preferred

Company Benefits

PSI offers full-time, benefits eligible employees a competitive total compensation package that includes paid leave, and options for employer sponsored group medical, dental, vision, short-term and long-term disability, life insurance, AD&D coverage, legal services, identity theft, and accident insurance.

Flexible spending account and health saving account options offer pre-tax savings for qualified medical, dental, and vision expenses.

The company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested. We invest in the professional growth of our employees through professional courses, certifications, and tuition reimbursement programs.

Last updated : 2024-04-23

Job Summary

JOB TYPE

Full Time

INDUSTRY

Business Services

SALARY

$40k-50k (estimate)

POST DATE

03/12/2024

EXPIRATION DATE

05/15/2024

WEBSITE

prosphere.com

HEADQUARTERS

ALEXANDRIA, VA

SIZE

200 - 500

FOUNDED

2006

TYPE

Private

CEO

JAMESINA TOOGOOD

REVENUE

$50M - $200M

INDUSTRY

Business Services

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Pro-Sphere is a Virginia-based company that offers services such as digital modernization, cloud migration, cybersecurity and program management for the federal government.

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The job skills required for Credentialing specialist include Microsoft Office, Health Care, Life Insurance, Written Communication, Data Entry, Quality Assurance, 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.

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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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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.

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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.

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Step 3: View the best colleges and universities for Credentialing Specialist.

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