Job Summary :

The Credentialing and Privileging Specialist is responsible for the timely, accurate, and compliant credentialing and privileging of Medical Staff providers and privileged practitioners in accordance with Medical Staff Bylaws and organization policies, regulatory requirements, accreditation standards, and applicable federal and state regulations. This position works under the supervision of the Manager of Medical Staff Services and interfaces with Medical Staff leaders and Senior Leadership. Essential functions and responsibilities include but are not limited to: Managing the credentialing and privileging process for assigned providers, including initial appointments, reappointments, changes in privileges, and other credentialing actions. Reviewing provider applications and supporting documentation for completeness, accuracy, and compliance. Obtaining primary source verification for credentials including but not limited to licensure, education, certification, and prior affiliations. Monitoring provider credentialing files for outstanding requirements and follow-up with providers and other responsible parties to ensure timely completion. Maintaining accurate and current provider demographic, credentialing, and privileging information within electronic credentialing database.

Qualifications:

Associate Degree required. Previous experience in a hospital, medical office, health system, or other healthcare administrative setting preferred. Must possess strong computer skills, demonstrating the ability to learn and effectively utilize computer-based systems and navigate multiple computer applications simultaneously. Strong attention to detail, organization, accuracy, and follow-through are essential, as well as the ability to manage multiple providers, deadlines, and priorities while maintaining confidentiality. Must demonstrate excellent written and verbal communication skills and be able to work independently while collaborating effectively with physicians, clinical staff, internal departments and external organizations. EOE AA M/F/Vet/Disability