Credentialing Specialist II

Hourly Wage Estimate: $21.87 - $32.81 / hour

Learn more about the benefits offered (  ) for this job.

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Credentialing Specialist II

Schedule:
Monday-Friday 9:30AM-6:00PM CST.

Seeking candidates that live in the Mountain Standard Time and Pacific Standard Time time zones.

The Credentialing Processing Center Specialist II
is responsible for s
afeguard
ing the
patient well-being and
elevating
clinical excellence across our healthcare enterprise by meticulously ensuring hospitals and other healthcare facilities
possess
comprehensive, verified practitioner legally required credentials. This role is pivotal in empowering informed decisions
regarding
practitioner access, directly
impacting
the thousands of lives under our care daily.

• Mastery communication and regulatory guidelines, policies, procedures, and internal systems, coupled with keen insight into practitioner 350+ internal customers, plus external customers.
• Forges collaborative partnerships with over 350+ healthcare facilities, customers, and stakeholders.
• Mastered competency and acquired extensive experience through review of Data Integrity Reviews, Specialist Reviews, and Compliance Reviews, that supports precise accurate identification of potential practitioner issues and flagging of practitioner risk.
• Adheres to stringent regulatory guidelines, Joint Commission Standards, Facility Bylaws and CPC standards.
• Ensures the flawless, timely, and accurate credentialing of medical and allied healthcare providers, upholding the highest standards of quality.
• Mastered through experience and exposure to complex credentialing documents and verifications the competency to discern, identify and elevate practitioner risk concerns by utilizing the policies, procedures, verification elements, or regulatory guidelines as validation. In addition, competency, and experience that supports the identification of potential risk outside of policy requirements.
• Orchestrates the comprehensive collection of all pertinent information, strategically managing follow-up for missing or incomplete documentation through effective communication and relationship building with practitioners and other external organizations.
• Identifies and analyzes potential compliance flags and master the skill set through experience to collaborate with practitioners on sensitive issues and other external organization, such as drug addiction centers or anger management centers, to accurate document or resolve sensitive and confidential practitioner issues.
• Mastered the ability to meticulously document resolution and/or unresolved complex issues and escalations as needed in practitioner files that may support future lawsuits.
• Possesses expertise knowledge to contribute valuable insight into the strategic development and implementation of policy frameworks, and participates in comprehensive audits, ensuring regulatory adherence.
• Provides strategic counsel to Managers and Directors regarding ambiguous information, and escalates critical issues identified during credentialing processes with expediency and precision.
• Maintains meticulous credentialing records, guaranteeing the accurate scanning and secure storage of all correspondence within mandated time frames.
• Upholds unwavering compliance with all governing policies, procedures, and Federal and State regulatory and accrediting agency requirements.

• Associate’s degree or equivalent work experience.
  Bachelor’s degree preferred
• 5+ years’ experience in healthcare credentialling with Parallon or HCA required
• Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance, preferred.
• Detailed working knowledge of the health care and credentialing industry, including medical-legal issues and laws, regulatory agencies, and other national standards preferred
• NAMSS Certification preferred.
• Remote…