Credentialing Specialist

Position Summary

Responsible for providing support to the medical staff and allied health staff with credentialing and privileging activities for initial and reappointment, assuring compliance to regulatory and accreditation standards, as well as the Orlando Health Bylaws, Rules & Regulations.

Responsibilities

Essential Functions

• Provides exceptional customer service to physicians and physician office staff members as well as internal customers, such as members of other departments. Educates physicians and physician office staff on the credentialing process and maintains ongoing contact with these individuals throughout the process.
• Obtains timely and accurate primary source verification for all credentialing functions. Completes accurate and timely data entry of all credentialing activity into physician credentialing systems. Interacts with IS Consultant to transition all manual processes to completion of processes within the physician credentialing data system. Maintains medical staff database for all physician and allied health credentialing and privileging activities.
• Identifies trends and assists in the development of action plans for purpose of performance improvement. Evaluates processes in departmental Policies & Procedures and makes recommendations for changes to Medical Staff Supervisor. Develop and distribute reports as necessary utilizing physician database. Timely completion of all assigned duties.
• Interacts with and provides support to department chairmen and leadership chairmen in the preparation of meeting calendars and meeting notices. Interacts with department chairman and leadership chairmen in presentation of initial credentialing and reappointment files in preparation for the Credentials Committee. Provides clerical support as needed to the Chief of Staff and Vice Chief of Staff in scheduling ad hoc meetings. Advances department meeting minutes to the appropriate leadership committee.
• Manages various human resources functions including hiring, work assignments, coaching plans, and performance counseling.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

 

Other Related Functions

• Assists the Medical Staff Supervisor in providing all credentialing, privileging and meeting support activities for the Orlando Health Medical Staff and its leadership.
• Ongoing review of processes to improve performance and meet customer needs.
• Maintains confidentiality.
• Assumes responsibility for professional growth and development.
• Skills necessary to maintain credentialing, meeting support activities, and reporting abilities relative to physician activity and statistics.

Qualifications

Education/Training

• High school graduate or equivalent.
• Knowledge of medical terminology.

 

Licensure/Certification

• None.

 

Experience

• Three (3) years experience credentialing/privileging or;
• One (1) year of credentialing/privileging experience and two (2) years of clinical experience.
• Associate degree in business, health care, accounting or related field may be substituted for two (2) years of experience.
• Bachelor degree in health, business or related field may be substituted for three (3) years of experience.
• Proficiency in Microsoft Word, Excel, Internet and significant proficiency in credentialing data system.