Credentialing Specialist

Job Description:

The Credentialing Specialist (CS) is responsible for facilitating Intermountain Health’s centralized verification office (CVO) program and will serve as the primary credentialing liaison for hospitals, providers and/or network participating providers regarding credentialing services.

M-F 8:00am-5:00pm. No weekends or holidays

• The CS will facilitate all aspects of Primary Source Verification program with accuracy and attention to detail, including but not limited to written verification of applicants education and/or training, experience, and direct communication with the source for all applications.
• They will review and ensure accuracy of provider information in credentialing software directly with the source for all applications.
• The CS processes initial credentialing and re-credentialing applications, capturing primary source documentation in computer databases, prepares and keeps reports of credentialing activities like accreditation, membership, or facility privileges, and ensures applications comply with applicable laws, regulations, procedures and policies.
• The CS needs to stay current on credentialing guidelines and make sure all records and applications are up to date and ready to be reviewed by the Hospital Medical Staff Office and Medical Staff Committees.
• They will have frequent contact with system-wide medical staff services professionals, administrators and practitioners, keep the Central Verification Office (CVO) Leaders apprised of problems or concerns, incorporate accreditation and regulatory standards requirements into medical staff activities, and work on maintenance of provider records including expirable items and other necessary documents.

• Medical Staff Credentialing
• Communication
• Organizing
• Health Insurance Portability & Accountability Act (HIPAA)
• Hospitals
• Health Care
• Data Entry
• Customer Service
• Critical Thinking
• Multi-Tasking

• Requires effective verbal and written communication skills and the ability to work well with a team.
• Must have intermediate level experience with Word, Excel, Adobe and One Note, and be comfortable learning a sophisticated database program.
• Must be able to work with a variety of health care professionals, work with minimal supervision, be self‑motivated, keep confidences, adapt to frequent interruptions, solve problems and make decisions, and possess organization and good communication skills.
• Working knowledge of TJC, NCQA standards as well as state and federal guidelines and requirements.
• Graduation from High School or equivalent, required.
• Knowledge of medical terminology required.

• Bachelor’s Degree from an accredited institution.
• Certified Provider Credentialing Specialist (CPCS) by the National Association of Medical Staff Services (NAMSS).
• Certified Professional Medical Services Management (CPMSM) by the National Association of Medical Staff Services (NAMSS).
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within five (5) years of employment.
• Minimum of one year experience in administrative work.
• Experience as a medical staff coordinator, medical staff credentials specialist or privileging coordinator.
• One year experience in healthcare, legal or insurance environment.

• Ongoing need to see and read information, labels, documents, monitors, identify equipment and supplies, and assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients and visitors requiring verbal communication and listening skills.
• Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy, including frequent computer use for typing and accessing information.
• For roles requiring driving, expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Nevada Central Office

Las Vegas, Nevada

40

$24.00 - $36.54

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits…