System Credentialing Specialist

About This Role

This role involves serving as the central contact for all medical staff applications for incoming providers, managing the credentialing process from application to primary source verification and background checks. This person ensures timely and accurate file completion by collaborating with various internal departments.

Responsibilities

• Serve as the central contact for all medical staff applications for incoming MHC providers for staff privileges or reappointment
• Monitor information collection and perform cognitive analysis of all information received, evaluating adequacy and quality
• Process provider applications, run primary source verifications, and complete background checks and other database queries
• Work with recruitment, payer enrollment, local medical staff contacts, ambulatory practice staff, and leadership to ensure accurate, complete, and timely file completion
• Verify all information garnered through investigation and follow-up processes
• Maintain HIPAA and regulatory compliance, adhering to Joint Commission standards, CMS guidelines, and other regulatory bodies

Requirements

• Bachelor's degree or equivalent experience

Qualifications

• Bachelor's degree or equivalent experience
• 2+ years experience in Medical staff/physician services, hospital credentialing, payer enrollment, or related field preferred

Nice to Have

• 2 years experience in Medical staff/physician services, hospital credentialing, payer enrollment, or related field
• Certified Professional Credentialing Specialist (CPCS) - Certification or eligibility/willingness to certify within 3 years of hire

Benefits

Certifications