Assures the credentialing of healthcare providers is conducted in accordance with organizational policies, operational procedures, and applicable governmental and regulatory agency regulations and standards. Performs activities associated with verification, tracking inquiries, and follow-up on problems which may delay completion of the file.
Obtains source verification of credentials in accordance with prevailing policies and procedures.
Tracks responses and follows-up on items not received within established cycleperiods.
Reviews completed files with management in accordance with established schedules.
Maintains credential records.
Produces management reports regarding operations performance and/or provider credentialing status for internal management and external providers using the health system's verification services.
Adheres to operating policies and procedures including delivery of completed work and use of resources.
Initiates correspondence to providers, users, health plans and others as necessary to obtain requisite credentialing information.
Informs management regarding the status of departmental operations and provider credentialing issues of concern.
Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Associates degree required, or equivalent combination of education and related experience.
1-3 years of relevant experience, required.
*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).