Specialist - Credentialing

Primary City/State: Virtual - Arizona Category: Compliance Shift: Day Department: Credentialing-Medical Staff Services Shift Hours: Monday – Friday, 8:00 AM – 4:30 PM Requirements: 1 year, credentialing, medical staff or administrative assistant including data entry, in a hospital or healthcare environment resulting in knowledge of medical terminology and professional physician interface Required 3 years, in a credentials or medical staff services setting Preferred Great care starts with great people. (Like you.) At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area. Responsibilities: JOB SUMMARY Under the general supervision, the Credentialing Specialist is responsible for providing credentialing and credentialing support to the Network Medical Staff through the processing of applications and reapplications to ensure that only qualified practitioners provide care within the network facilities. Provides credentialing support to the centralized appointment and reappointment process including reports and obtaining required data from Quality Assurance profiles and National Practitioner Data Bank reports, in accordance with the National Commission on Quality Assurance (NCQA), The Joint Commission, DNV and the Arizona Department of Health Services (DHS) standards. ESSENTIAL FUNCTIONS Provides credentialing support to the credentialing manager. Maintains a sound working knowledge of credentialing and provides consultation to the medical staff regarding credentialing, to ensure all processes are in compliance with state statutes and regulatory agencies as demonstrated by observation. Responsible for timely processing of initial applications and reappointment applications for completeness and in accordance with Medical Staff standards. Secures appropriate peer competency references and prepares credentials files. Obtains primary source and other verifications in accordance with established guidelines. Communicates with applicants during credentialing process to ensure timely and expeditious completion of process. Researches incidents, malpractice claims, advisory letters/letters of concern etc. and request appropriate follow-up information from practitioner or other sources as indicated. Maintains the credentialing database . Updates primary source data in the Midas database. Ensures data is accurately entered as evidenced by audit. Prepares reports in compliance with requests for information as demonstrated by documentation. Maintains adherence to professional confidentiality standards established within the Department and in accordance with legal, ethical and hospital and medical staff policies. Assures data security and confidentiality by use of appropriate labeling of information and storage, and appropriately securing cabinets and drawers. Coordinates all activities of the initial phase of Medical Staff and Allied Health applicants. Receives and data enters information for various applications and follows through on missing information. Enters information and updates into the date base to include complete biographical profile on new physician and updates and entries for provisional and biennial reappointment of existing medical staff. Maintains master physician database. Maintains physician files in an orderly manner, making sure all appropriate documents are filed. Maintains provide rosters for portal throughout the network. Maintains and regularly updates specific biographical data in the systems. Generate reports as needed by systems for inter-department use. Phones physician offices regarding meeting attendance, malpractice coverage and DEA certification, etc. Notifies all database users of any provider’s additions and/or changes monthly. Downloads information from the Internet and conducts searches as needed for project work. Maintains and keeps all departmental databases at the time of appointment and reappointment. Maintains and updates the Network Webpage Master for Hospital's Website. Responsible for the timely response of Affiliation Letters. Ensures all physician documents are not expired Performs a full range of clerical functions in support of department staff and management including document preparation, filing, office administration, office equipment maintenance and supply procurement is performed within departmental standards and within budgetary guidelines as evidenced by observation and audit. EDUCATION High School Diploma or GED Required Other / Certificate College or professional coursework in medical terminology, health care, documentation, or law. Preferred EXPERIENCE 1 year, credentialing, medical staff or administrative assistant including data entry, in a hospital or healthcare environment resulting in knowledge of medical terminology and professional physician interface Required 3 years, in a credentials or medical staff services setting Preferred LICENSE AND CERTIFICATIONS Certified Provider Credentialing Specialist (CPCS) - Certification, Certification Preferred We're all in for your career. Expert care from experts who care. At HonorHealth, you’ll find something special. Our culture is built on warmth and neighborly kindness, but behind every smile is a highly skilled professional with deep expertise and unwavering dedication. We’re delivering a healthcare experience that simply feels better through: • Nine acute-care hospitals • Over 200 primary, specialty and urgent care centers • More than 17,000 team members and 4,000 medical staff Since 1927, we’ve been focused on doing what matters most — caring for people and communities across the greater Phoenix area. From humble beginnings to one of Arizona’s largest nonprofit healthcare systems, we’re just as driven as we were a century ago. Come join us and go all in for your career. 🔗 Helpful links 💼 Benefits 🖥️ Career site 🤝 Culture 📄 Hiring Process 🏥 Locations 🖥️ HonorHealth.com Join our talent community here! 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