Credentialing Specialist
$47,528–$71,240 year
HybridSaint Cloud, Minnesota, United States
Job Summary
Prepare files for medical staff credentialing, privileging, and recredentialing while ensuring compliance with Joint Commission, NCQA, CMS, and hospital policies. Collaborate with physician reviewers to address red flag issues and present files at system-wide Credentialing Committee discussions. Accurately enter demographics, education, training, and employment verifications into the credentialing database and communicate with practitioners via phone, fax, or email to facilitate document completion. Engage in activities to develop and improve documents, policies, and procedures supporting day-to-day operations. This role ensures physicians and advanced practice providers are qualified to provide quality patient care within CentraCare.
Required Qualifications
- Associate Degree or minimum of 3 years equivalent experience
- 2 years hospital and/or Health Care related experience
- Must be able to work under pressure and meet deadlines
- Self-motivated with the ability to work independently
- Familiar with Joint Commission, NCQA, Centers for Medicare/Medicaid (CMS) and other accrediting agency standards
- Demonstrate attention to detail, with a high degree of accuracy and organizational ability
- Strong and effective verbal, written and interpersonal communication skills
- Knowledge in MS Office, office equipment, computer systems, and office administration
Desired Qualifications
- Certified Provider Credentialing Specialist CPCS or CPMSM certification through NAMSS
- MN Association Medical Staff Services (MAMSS) membership
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