What are the responsibilities and job description for the Lead Senior Credentialing Specialist (FT) position at Professional Performance Development Group, Inc?
Qualifications:
Minimum Education/Experience: Ten years of experience in medical credentialing to include knowledge of the credentialing and privileging process, the required credentials for healthcare professionals, knowledge of appropriate sources used to complete Prime Source Verification, work history verifications, sanction checks and databank queries. Five years of credentialing experience with the DoD utilizing JCCQAS.
Job Duties and Responsibilities:
The duties include but are not limited to the following:
Minimum Education/Experience: Ten years of experience in medical credentialing to include knowledge of the credentialing and privileging process, the required credentials for healthcare professionals, knowledge of appropriate sources used to complete Prime Source Verification, work history verifications, sanction checks and databank queries. Five years of credentialing experience with the DoD utilizing JCCQAS.
Job Duties and Responsibilities:
The duties include but are not limited to the following:
- Responsible for management of the internal operations within the CVO.
- Contacts medical office staff, educational institutions, employers, licensing and certifying agencies, to obtain and complete the verification of credentials.
- Obtains required credentials and complete PSV of the credentials from the originating source or designated agent, date stamps the documentation upon receipt.
- Updates the appropriate screens within CCQAS to capture the credential and PSV of the credential.
- Converts documentation to a PDF format, scans, appropriate names, and uploads the documentation to the provider’s electronic credentials file.
- Completes credentialing tasks routed to the DHACCVO for action and appropriately updates the provider’s electronic credentials file.
- Identifies and reports potential “red flags” to the requestor and submits required credentials verification summaries, completes verification tasks within CCQAS and scans, appropriately names and uploads required documentation to CCQAS.
- Audits provider credentials application and credentials file for compliance with requirements outlined in regulatory guidelines.
- Transfers provider credentials files to MTF credentials office or training office as appropriate.
- Closes out and inactivates electronic JCCQAS records when appropriate.
- Responds to queries/request for information and resolves originating request or routes the request to the appropriate individual for resolution.
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