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Job Summary:

The Credentialing Specialist assists in the planning, developing, organizing and processing the operations for the credentialing appointments/reappointments and terminations of the Medical Staff Office in order to contribute to meeting the mission and goals of the Department and Hospital. This role ensures all credential/quality files are created and maintained accurately and confidentially.

Core Responsibilities and Essential Functions:

• Updates/maintains MD Staff database. Runs monthly reports. Ensures all credential/quality files are created and maintained accurately and confidentially. Updates/maintains privilege forms/forms in database. Completes online verifications on initial and reappointments.
• Completes and meets deadlines for credentialing process including creating appointment/reappointment letters. Mails letters with a copy of privileges to the practitioners, ensuring copy of letters and privileges are in the Credentials files. Creates credential files for new appointments. Files reappointment information for files that have been processed through the Credentials Committee, turn and enter practitioners’ information in the database after Board approval.
• Assist the Supervisors Medical Staff Office, Chief Medical Officer, Director CMO Business Operations and Administrative Assistant to the CMO, as necessary. Assists Supervisors Medical Staff Office with Annual Medical Staff Meeting. Assists with delegated annual reviews by managed care companies. Manages office expenditures including all office/supply orders for the department and the supply budget in adherence with rules and regulations.
• Assists physicians and other credentialed health care professionals to adhere to and interpret the Medical Staff Bylaws, Rules and Regulations, and Credentialing Policy. 

Required Minimum Education:

Highschool diploma or GED

Required Minimum Experience:

2 years or more of experience in credentialing/privileging providers, or provider enrollment, or revenue cycle in a healthcare setting.

Required Minimum Skills:

Microsoft Word, Excel and PowerPoint

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