- Complete pre-application reviews when assigned by Credentials Manager
- Assist providers with credentialing inquiries
- Process initial credentialing and re-credentialing applications
- Screen practitioners' applications and supporting documentation to ascertain eligibility
- Contract external sources for verification of credentials information, including licensing agencies, university and hospital training program administrators, certification boards, liability insurance carriers, hospital officials and credentials staff, and other practitioners
- Reliably document all data in credentialing software
- Ensure compliance with applicable laws, regulations, procedures, and policies
- Maintain confidentiality of credentials file, information, and peer review
- Assess requests for clinical privileges by applying credentialing criteria, knowledge of institutional criteria, and medical staff governing documents; seek guidance from Credentials Specialist III or Credentials Manager for next steps
- Monitor expiration dates for critical documents such as license, insurance, and notify providers of possible expiration; obtain current documents as appropriate
- Prepare credentialing files for review for appointment and reappointment, for presentation in Virtual Committee or DocuSign, calling attention to red flags
- Prepare appointment and reappointment letters
- High School Diploma or GED (Required)
- Formalized Training
- No Certification, Competency or License Required
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Credentials Specialist 2 - Charleston, United States - CAMC Health System
Description
Job Summary
Adhere to and apply standards outlined in the CAMC Medical Staff Governing Documents to ensure all applications are processed in accordance with accrediting body and other regulatory standards.
Validate and analyze all expirable documents provided by medical, advanced practice professional, and and clinical assistant (if applicable) applicants and credentialed providers through primary source verification.
Responsibilities
Patient Group Knowledge (Only applies to positions with direct patient contact) The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages.
Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.
Common Duties and Responsibilities (Essential duties common to all positions) 1. Maintain and document all applicable required education. 2. Demonstrate positive customer service and co-worker relations. 3. Comply with the company's attendance policy. 4. Participate in the continuous, quality improvement activities of the department and institution. 5. Perform work in a cost effective manner. 6.Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations.
7. Perform work in alignment with the overall mission and strategic plan of the organization. 8. Follow organizational and departmental policies and procedures, as applicable. 9. Perform related duties as assigned.Education
Status: Full Time Regular 1.0
Location: General Hospital
Location of Job: US:WV:Charleston
Talent Acquisition Specialist: Tamara B. Young
