What are the responsibilities and job description for the Specialist, Medical Credentialing - FT position at Three Crosses Regional Hospital?
Medical Credentialing Specialist FT Position Available
If you're looking for a place to call home and grow your career, Three Crosses Regional Hospital is looking for you! We are seeking a Medical Credentialing Specialist to join our team that is committed to clinical excellence and building a patient-centered culture.
Three Crosses Regional Hospital is an advanced, independent healthcare organization led by a local team of professionals dedicated to delivering high-quality patient care and being the first choice for patients and providers in the communities we serve.
Primary Job Responsibilities:
- Coordinate provider credentialing, privileging, appointments, reappointments, and payer enrollment activities.
- Collect, verify, and maintain practitioner credentials, licenses, certifications, DEA registration, and malpractice insurance.
- Maintain accurate and confidential credentialing files and databases.
- Monitor expiring credentials and ensure timely renewals and reappointments.
- Prepare credentialing files for committee review and approval.
- Coordinate Medicare, Medicaid, and commercial payer enrollment and revalidation.
- Serve as a resource for providers regarding credentialing, onboarding, and enrollment requirements.
- Assist with Medical Staff meeting preparation, documentation, and record management.
- Prepare reports related to credentialing status, provider enrollment, and compliance.
- Support Joint Commission, CMS, payer audits, and accreditation surveys.
- Maintain HIPAA compliance and protect confidential information.
- Prepare credentialing files for committee review and approval.
- Coordinate Medicare, Medicaid, and commercial payer enrollment and revalidation.
- Serve as a resource for providers regarding credentialing, onboarding, and enrollment requirements.
- Assist with Medical Staff meeting preparation, documentation, and record management.
- Prepare reports related to credentialing status, provider enrollment, and compliance.
- Support Joint Commission, CMS, payer audits, and accreditation surveys.
- Maintain HIPAA compliance and protect confidential information.
Requirements:
- Required: High School Diploma or equivalent
- 3 years’ experience in provider credentialing in a managed care setting.
- Preferred: CPCS certification
- Three Crosses Regional Hospital is an Equal Opportunity Employer.