Credentialing Quality Specialist

Posted:
9/4/2024, 7:18:27 AM

Location(s):
Colorado, United States ⋅ Arizona, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Medical, Clinical & Veterinary

Workplace Type:
Hybrid

Primary City/State:

Arizona, Arizona

Department Name:

BH Central Verificatn Ofc-Corp

Work Shift:

Day

Job Category:

Clinical Support

Primary Location Salary Range:

$21.63 - $32.45 / hour, based on education & experience

In accordance with State Pay Transparency Rules.

The future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.

Banner Health has been recognized by Becker’s Healthcare as one of the 150 top places to work in health care. In addition, we recently made Newsweek’s list of America’s Greatest Workplaces 2023 for Diversity. These recognitions reflect Banner Health's investment in team members' professional development, wellness benefits, and continued education. It highlights our commitment to advocating for diversity in the workplace, promoting work-life balance, and boosting employee engagement.

As a Credentialing Quality Specialist, you will work with a dynamic, high-volume Quality Review team that provides highly skilled support to CVO teams, hospital medical staff departments, providers, and other hospital personnel under moderate supervision. This is a remote position, Monday - Friday during normal business hours (Mountain Standard Time). There are periodic onsite team meetings and preference is given to candidates residing in Colorado or Arizona. 

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits. 

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY
This position provides highly skilled support to CVO teams, hospital medical staff departments, physicians, and other hospital personnel under moderate supervision.

CORE FUNCTIONS
1. Coordinates all aspects of medical staff credentialing file review and analysis, as assigned; includes researching and preparing information for medical staff leaders, providing professional assistance regarding initial and reappointment applications.

2. Ensures application quality review process is completed within appropriate timeframes. May request additional information from external sources when necessary to ensure file is accurate and complete. Drafts correspondence as delegated by supervisor.

3. Serves as a resource regarding regulatory and credentialing requirements.. Interacts directly with a variety of internal and external customers.

4. In consultation with supervisor, CVO credentialing director, and medical staff services leader, participates in hearing committees as needed. Uses judgment and discretion to maintain peer review protection for hospital and medical staff.

5. Understands and maintains an accurate, secure and updated database of physician and allied health information. May utilize various internal databases to gather and analyze physician and allied health data used in the file review process.

6. Requires high degree of confidentiality and critical decision making. Requires moderate direction and guidance. May interact with members of the administrative staff of the hospital, members of the medical and affiliated staff, medical staff officers, medical staff department chairs, section chiefs, physician and other professional applicants, attorneys, medical staff professionals at other facilities, state licensing bodies, other departmental personnel and patients. All require courtesy, tact, patience, cooperation and confidentiality.



MINIMUM QUALIFICATIONS

Must possess strong knowledge of medical staff credentialing and privileging processes as normally obtained through one to two years of experience in a hospital medical staff services department. Requires knowledge of medical terminology, regulatory requirements, and professional office practices.

Requires experience with credentialing file review, and interacting with physicians in highly sensitive situations. Must possess strong verbal and written communication skills. Requires astute judgment in human relations skills to interface and communicate in an articulate manner with medical staff, administrators, legal counsel and hospital personnel.

Requires the ability to work with common office software and equipment.

PREFERRED QUALIFICATIONS


Two years of college education is preferred. National Certification as a Medical Staff Services Professional or Credentialing Specialist is preferred. Knowledge of medical staff computer software programs is desirable. Experience with MSOW Credentialing Software preferred.

Additional related education and/or experience preferred.

Anticipated Closing Window (actual close date may be sooner):

2025-01-02

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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