Credentialing Specialist I- Medical Staff

SUMMARY: 

Verifies medical training, experience and other attributes required of medical health care providers. Ensures the completion of files and monitors expired documents during the members’ appointment period.

ESSENTIAL FUNCTIONS :

Coordinates, monitors and maintains the credentialing and recredentialing process.

Reviews applications and other data for accuracy and completeness.

Performs primary source verification of initial and reappointments applications by preparing requests for information letters, tracking responses and follow-up for needed information.

Obtains licensure, insurance and other certificates at time of reappointment or as they expire and enters them in our database.

Enters accurate and up-to-date data for each applicant into the database and responds to verification requests.

Ensures the accuracy of documentation to support the request for privileges by maintaining good working relationships with clinical departments, Medical Staff leadership and professional agencies.

Assists in compliance with the accrediting and regulatory agencies in regards to credentialing, while developing and maintaining a working knowledge of the required statutes and laws.

Answers phones, makes copies, prepares mailings and maintains files.

Assists with timely maintenance and accuracy of database.

Adheres to TMC organizational and department-specific safety, confidentiality, values, policies and standards.

Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION:  High school diploma or general education degree (GED), or an equivalent combination of relevant education and experience.

EXPERIENCE:  Two (2) years experience performing medical staff credentialing.

LICENSURE OR CERTIFICATION:  None required