Credentialing Specialist at AdventHealth

Date Posted: 5/5/2022

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Job Snapshot

  • Job Schedule
    Part-Time
  • Location:
    Calhoun, GA
  • Date Posted:
    5/5/2022
  • Job ID:
    22000087
  • Job Family
    Compliance
  • Shift
    1 - Day

Job Description


Description

Credentialing Specialist – AdventHealth Georgia

All the benefits and perks you need for you and your family:

  • Benefits from Day One
  • Paid Days Off from Day One
  • Career Development
  • Whole Person Wellbeing Resources
  • Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s 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: Part Time

Location: 1035 Red Bud Rd Calhoun, GA 30701

The role you’ll contribute:

The Credentialing Specialist supports departmental activities to ensure quality in conducting, maintaining, and communicating provider credentialing, privileging, and source verifications. Serves as a resource to, and collaborates with, others to advance the quality of providers and patient safety of the facility.

The value you’ll bring to the team:

  1. Conducts, participates in, and maintains credentialing and privileging.
  • Determines applicant’s initial eligibility for membership/clinical privileges.
  • Compiles, evaluates, and presents the provider-specific data collected for review by one or more decision making bodies.
  • Analyzes application and supporting documents for completeness and informs the provider of the application status, including the need for additional information.
  • Performs initial or reappointment processes for eligible providers.
  • Processes requests for privileges.
  1. Manages the credentialing and/or privileging process.
  • Applies clearly defined credentialing and/or privileging processes to all providers.
  • Directs initial or reappointment processes for eligible providers.
  • Oversees delegated credentialing process and completes all required activities.
  1. Conducts, participates in, and maintains primary source verification.
  • Obtains and evaluates information from primary sources.
  • Recognizes, investigates, and validates discrepancies and adverse information obtained from the application, primary source verifications, or other sources.
  • Verifies and documents expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards. Contacts the provider/credentialing contact for updated information. Prepares correspondence, which includes preparing suspension letters and obtaining signatures.
  • Provides responses to external queries regarding provider’s status.
  1. Manages and complies with accreditation and regulatory standards.
  • Participates in an ongoing assessment of governing documents (bylaws, rules and regulations) to ensure continuous compliance. Maintains knowledge of governing documents as well as accreditation standards.
  • Obtains and evaluates practitioner sanctions, complaints, and adverse data to ensure compliance.
  • Maintains credentialing database to ensure that accurate and current information is available to all stakeholders (i.e. employee access to privilege inquiry and photo display).
  1. Facilitates medical staff functions by providing clerical support.
  • Performs and coordinates meeting logistics, documentation preparation, attends meetings, records minutes, and performs follow up for provider related activities.
  • Coordinates the assemblage of credentialing application packets and orientation materials. Notifies the providers of upcoming reappointment processes.
  • Distributes ED call calendar by the 25th of each month and daily when schedule revisions occur, maintenance of the current medical staff/medical staff committee roster (i.e. blast fax). 5
  • Prepares monthly Medical Staff calendar through collaboration with the applicable Medical Staff Committee Chair and disseminates to the Medical Staff, Administration and Hospital Departments.
  • Provides reception support, opens, sorts, and distributes all mail received daily. Orders office supplies and performs other office functions.
  • Maintains minute books, making sure that a final copy of all minutes and correspondence are maintained within the Medical Staff office.
  • Develops and maintains organized filing and record system which includes historical pertinent budgetary records and confidential peer review files for medical staff members and allied health professionals.
  • Assists with other duties as assigned.
Qualifications

The expertise and experiences you’ll need to succeed:  

  • Associates Degree
  • Proficiency in Microsoft Word, Excel, and Power Point.

Knowledge and Skills Preferred:

    • Knowledge of medical terminology; MSOW experience; Bachelor’s degree

Education and Experience Required:

  • Requires two years credentialing experience preferably in a healthcare setting. Excellent written and oral presentation skills. Ability to multi-task, prioritize projects, and manage time efficiently and effectively.

Education and Experience Preferred:

  • Bachelor’s Degree, preferable in secretarial science or office administration.
  • Two years of experience in hospital or related health area.

LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:

  • NAMSS Certified Provider Credentialing Specialist required. Must sit for exam upon eligibility and obtain certification.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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