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Credentialing and Privileging Specialist

CaroMont Health

Gastonia, NCJobSeen 2w agoSeen in employer's feed 2 days ago

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At a glance

Compensation
No compensation found
Location
Gastonia, NC
Work Authorization
Not specified

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Requirements

Credentials this posting asks for.

Associate's degree

Job overview

The Credentialing and Privileging Specialist ensures timely, accurate, and compliant credentialing and privileging of medical staff providers and privileged practitioners, adhering to bylaws, organizational policies, regulatory requirements, accreditation standards, and federal and state regulations, while working under the Manager of Medical Staff Services and coordinating with medical staff leaders and senior leadership.

Skills & qualifications

RequiredNice to have

Skills

Computer SkillsAbility to Learn Computer-Based SystemsNavigate Multiple Computer ApplicationsAttention to DetailOrganizationAccuracyFollow‑ThroughWritten CommunicationVerbal CommunicationIndependent WorkCollaborative Skills

Qualifications

Associate Degree

Full job description

Job Summary: The Credentialing and Privileging Specialist is responsible for the timely, accurate, and compliant credentialing and privileging of Medical Staff providers and privileged practitioners in accordance with Medical Staff Bylaws and organization policies, regulatory requirements, accreditation standards, and applicable federal and state regulations.

This position works under the supervision of the Manager of Medical Staff Services and interfaces with Medical Staff leaders and Senior Leadership. Essential functions and responsibilities include but are not limited to:

  • Managing the credentialing and privileging process for assigned providers, including initial appointments, reappointments, changes in privileges, and other credentialing actions.

  • Reviewing provider applications and supporting documentation for completeness, accuracy, and compliance.

  • Obtaining primary source verification for credentials including but not limited to licensure, education, certification, and prior affiliations.

  • Monitoring provider credentialing files for outstanding requirements and follow-up with providers and other responsible parties to ensure timely completion.

  • Maintaining accurate and current provider demographic, credentialing, and privileging information within electronic credentialing database.

Qualifications: Associate Degree required. Previous experience in a hospital, medical office, health system, or other healthcare administrative setting preferred. Must possess strong computer skills, demonstrating the ability to learn and effectively utilize computer-based systems and navigate multiple computer applications simultaneously. Strong attention to detail, organization, accuracy, and follow-through are essential, as well as the ability to manage multiple providers, deadlines, and priorities while maintaining confidentiality. Must demonstrate excellent written and verbal communication skills and be able to work independently while collaborating effectively with physicians, clinical staff, internal departments and external organizations.

EOE AA M/F/Vet/Disability

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