CommonSpirit Health
Job Summary and Responsibilities
Are you a meticulously organized professional with a keen eye for detail and a passion for ensuring excellence in healthcare? Do you thrive on precision, compliance, and being the gatekeeper of quality medical personnel? St. Michael Medical Center in vibrant Bremerton, WA, is actively seeking a highly skilled and dedicated Credentialing Specialist to join our dynamic Medical Staff Services team! If you're ready to play a critical role in upholding the highest standards of patient care by ensuring our providers are impeccably qualified, then this is your exciting opportunity!
Essential Functions
Performs credentialing and re-credentialing processes according to departmental policies and procedures, various accreditation standards, health plan, state and Federal requirements.
Receives and reviews submitted applications for completeness and compliance with instructions for preparation; ensures the timely completion of applications by communicating with and assisting the applicants in submitting all documentation necessary to process the application; identifies deficiencies and follows up to gather missing or incomplete data.
Verifies all information (i.e., education/experience, training, qualifications, current/past affiliations, licensure, etc.) contained in the credentialing application to ensure that it is timely and accurate; requests and obtains documentation from a variety of sources (i.e., licensing agencies, educational institutions, insurance carriers, previous employers, etc.) in accordance with established procedures; obtains information regarding complaints and/or medical malpractice claims history; follows up as necessary to gather clarifying data; identifies problematic information and refers to higher level authority.
Uses discretion and independent judgment in determining the need for deviation from standard processes or more detailed investigation, including those involving fees, or that would cause processing delays in order to clarify, verify and/or confirm information contained in the credentialing application.
Provides assistance and guidance to physicians and professional providers through the hospital privileging processes.
Produces verification letters and prepares files containing all required supporting documentation; sends completed application files to Medical Staff Office for review.
Job Requirements Required
Two (2) years practitioner credentialing experience or
Three (3) years administrative experience, that demonstrates attainment of the requisite job knowledge skills/abilities
Preferred
Three (3) years administrative experience, that demonstrates attainment of the requisite job knowledge skills/abilities, preferably in a healthcare setting
Certified Provider Credentialing Specialist, upon hire
Where You'll Work Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved through strategic partnerships and expansions to serve communities across the Puget Sound area. We offer comprehensive health services, from routine wellness to complex disease management, supported by a network of 10 hospitals and nearly 300 care sites. Join a team dedicated to excellent, modern, patient-centered care.
Pay Range $26.06 - $36.81 /hour
Seniority Level Not Applicable
Employment Type Full-time
Job Function Health Care Provider
Industries
Wellness and Fitness Services
Hospitals and Health Care
Medical Practices
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Essential Functions
Performs credentialing and re-credentialing processes according to departmental policies and procedures, various accreditation standards, health plan, state and Federal requirements.
Receives and reviews submitted applications for completeness and compliance with instructions for preparation; ensures the timely completion of applications by communicating with and assisting the applicants in submitting all documentation necessary to process the application; identifies deficiencies and follows up to gather missing or incomplete data.
Verifies all information (i.e., education/experience, training, qualifications, current/past affiliations, licensure, etc.) contained in the credentialing application to ensure that it is timely and accurate; requests and obtains documentation from a variety of sources (i.e., licensing agencies, educational institutions, insurance carriers, previous employers, etc.) in accordance with established procedures; obtains information regarding complaints and/or medical malpractice claims history; follows up as necessary to gather clarifying data; identifies problematic information and refers to higher level authority.
Uses discretion and independent judgment in determining the need for deviation from standard processes or more detailed investigation, including those involving fees, or that would cause processing delays in order to clarify, verify and/or confirm information contained in the credentialing application.
Provides assistance and guidance to physicians and professional providers through the hospital privileging processes.
Produces verification letters and prepares files containing all required supporting documentation; sends completed application files to Medical Staff Office for review.
Job Requirements Required
Two (2) years practitioner credentialing experience or
Three (3) years administrative experience, that demonstrates attainment of the requisite job knowledge skills/abilities
Preferred
Three (3) years administrative experience, that demonstrates attainment of the requisite job knowledge skills/abilities, preferably in a healthcare setting
Certified Provider Credentialing Specialist, upon hire
Where You'll Work Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved through strategic partnerships and expansions to serve communities across the Puget Sound area. We offer comprehensive health services, from routine wellness to complex disease management, supported by a network of 10 hospitals and nearly 300 care sites. Join a team dedicated to excellent, modern, patient-centered care.
Pay Range $26.06 - $36.81 /hour
Seniority Level Not Applicable
Employment Type Full-time
Job Function Health Care Provider
Industries
Wellness and Fitness Services
Hospitals and Health Care
Medical Practices
#J-18808-Ljbffr