Medical Staff Credentialing Specialist processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist handles and resolves inquiries regarding credentialing information, process, or status. Requires a high school diploma. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor. The Medical Staff Credentialing Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Medical Staff Credentialing Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
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Facility: GSS National Campus
Location: Sioux Falls, SD
Address: 4800 W 57th St, Sioux Falls, SD 57108, USA
Shift: Day
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $21.50 - $34.50
Pay Info: Pay starts at $21.50 and increases according to years of applicable experience.
Job Summary
The Credentialing Specialist is responsible and accountable for oversight of tasks and processes developed to facilitate the credentialing process for initial and reappointment applications to medical staff, professional health staff and allied health staff. Responsibilities to include: overseeing the timelines and workflow processing of the reappointment cycles; prioritizing work to meet anticipated start dates and reappointment expiration; Accountable for the completeness and identifying issues requiring additional information or investigation on applications; overseeing the accuracy of application data entry and verification requests; performing the final review of processed verifications for quality and content; developing correspondence to obtain additional information as needed; facilitating Committees in preparation of agenda materials and follow-up of recommendations; coordinating communication of final credentialing recommendations to all parties; generating audits and reports to support/document the verifications and credentialing process; facilitating projects; and initiation of the provider application process.
Models excellent customer service skills and take initiative to meet the needs of all to ensure customer focus and a positive experience. Communicates effectively and with a high level of diplomacy with providers. Must be able to work on multiple daily tasks with efficiency and high-quality accuracy while handling multiple internal and external customer communications. Responsible for planning work to meet regulatory and customer defined deadlines, which requires coordination to minimize redundancy of work when multiple organizations share common providers.
Qualifications
Bachelor's degree required. In lieu of education, leadership may consider an Associate’s degree and 3 years of applicable experience.
Minimum of two years of experience in credentialing, provider services, administrative support, business or healthcare experience preferred.
Benefits
Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .
Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .
Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.
Req Number: R-0179013
Job Function: General Administration
Featured: No
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