What are the responsibilities and job description for the Credentialing specialist position at VMFH Division Support Services?
Overview
In 2020 united in a fierce commitment to deliver the highest quality care and exceptional patient experience Virginia Mason and CHI Franciscan Health came together as natural partners to build a new health system centered around the patient : Virginia Mason Franciscan Health.
Our combined system builds upon the scale and expertise of our nearly 300 sites of care including 11 hospitals and nearly 5000 physicians and providers.
Together we are empowered to make an even greater impact on the health and well-being of our communities.
While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that mayinclude health / dental / vision, FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility, and more!
Responsibilities
This amazing opportunity is a Remote position.
JOB SUMMARY
Performs the provider credentialing and database maintenance processes based on department and organizational policy, procedure, and standards and guidelines set forth by The Joint Commission (TJC) and the National Committee for Quality Assurance (NCQA), URAC, State and Federal Government, and health plan payors.
Incumbents are responsible for : 1) ensuring accurate and timely credentialing and subsequent submission of provider information to support appointing and claims submission;
ESSENTIAL DUTIES :
Performs credentialing and re-credentialing processes according to departmental policies and procedures, various accreditations standards, health plan, state and Federal requirements.
Provides assistance and guidance to physicians and professional providers through the hospital privileging processes.
Prepares files, letters and summaries for Medical Staff Office and / or Franciscan Medical Group (FMG) Credentialing Committee review.
Maintains all written / verbal correspondence and data collection records regarding provider status and credentialing process.
Assists with productivity reporting.
Assists in preparation for health plan delegation oversight audits.
Qualifications
Education / Work Experience :
Two (2) years practitioner credentialing experience, or three (3) years administrative experience, that demonstrates attainment of the requisite job knowledge skills / abilities, preferably in a healthcare setting.
Licensure / Certification
Certified Provider Credentialing Specialist (CPCS) preferred, or able to obtain within two years of meeting prerequisites.
Last updated : 2024-07-19
Salary : $25 - $34