What are the responsibilities and job description for the Credentialing Specialist position at AdventHealth PHSO Resources?
Credentialing Specialist AdventHealth PHSO
All the benefits and perks you need for you and your family:
Benefits from Day One
Paid Days Off from Day One
Student Loan Repayment Program
Whole Person Wellbeing Resources
Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Full Time
Shift: Monday Friday 8:00am to 5:00pm
Location: Remote, Maitland, FL
The role you'll contribute:
Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process. This position handles credentialing, including initial appointment, reappointment, and expirables processes for physicians and allied health professionals. Ensures compliance with accrediting and regulatory agencies and maintains a working knowledge of relevant statutes and laws. Responsible for the accuracy and integrity of the credentialing database system and related applications. Additionally, this role actively promotes outstanding customer service and maintains respectful relationships. Responsibilities for this role include coordinating activities, ensuring compliance, maintaining database accuracy, and participating in customer service.
The value you will bring to the team:
Assists with managed care delegated credentialing audits and conducts internal file audits.
Utilizes the credentialing database to optimize efficiency, perform queries, report, and document generation, and submit practitioner database reports in accordance with the Health Care Quality Improvement Act.
Monitors the initial, reappointment, and expirables process for all AHS-employed physicians, allied health professional staff, delegated and community CIN providers affiliated with AHS.
Ensures compliance with regulatory bodies as well as medical staff bylaws, rules, and regulations, policies and procedures.
Achieves productivity standards as determined by management.
Other duties as assigned.
Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring accuracy and completeness.
Conducts thorough background investigation, research, and primary source verification of all components of the application files, ensuring all items are current and noted in detail in the system of record.
Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up.
Prepares credentials file for completion and presentation to the Adventist Health Systems (AHS) Delegated Credentialing-affiliated credentialing committees within AHS, including Clinically Integrated Network (CIN) committees, ensuring files comply with established time periods.
Processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.
Responds to inquiries from other healthcare organizations and interfaces with internal and external customers on day-to-day privileging issues as they arise.
The expertise and experiences you'll need to succeed:
Minimum qualifications :
High School Diploma or Equivalent
1 year of experience administrative support in a healthcare settingPreferred Qualifications:
Certified Professional Medical Staff Management CPMSM Preferred
Certified Provider Credentialing Specialist CPCS Preferred
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Population Health
Organization: AdventHealth PHSO Resources
Schedule: Full-time
Shift: 1 - Day
Req ID: 25045382
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
