Medical Staff Credentialing Specialist

Position Summary:

Midnight Sun is seeking a Medical Staff Credentialing Specialist in support of a federal support services contract at the Indian Health Service (IHS). The Medical Staff Credentialing Specialist is responsible for coordinating and managing the credentialing, recredentialing, privileging, and compliance activities for medical staff. This position ensures that all providers meet organizational, regulatory, accreditation, and payer requirements and maintains accurate credentialing records in accordance with applicable standards. This position is pending contract award.

Duties/Responsibilities:

• Maintain clear communication on all credentialing activities with the facility Clinical Director, Albuquerque Area Credentialing Consultant, and CEO.
• Coordinates the initial and reappointment application process for all credentialed providers and reviews supporting documentation.
• Initiates and accepts all applications and verifies education, training, licensure, specialty boards, National Practitioner Data Bank reports, and professional references.
• Ensures the clinical privileges requested are consistent with education and training requirements within their specific specialty. Assists in development and maintenance of privileging forms, templates, and criteria (in consultation with medical staff leadership) consistent with bylaws, regulatory, and accrediting standards.
• Assembles all verified information and prepares the credentialing file for the Medical Executive Committee and Governing Board, within the timeframes dictated by the bylaws of the organization.
• Monitor and track the expiration dates of professional licensure, DEA licensure, prescribing licensure, basic life support certification, and obtaining primary source verification on all initial applications, reappointment applications and upon renewal of license. Notifies the medical staff leadership on any adverse findings.
• Notifies each credentialed staff member approximately 3 months before the expiration of the individual's term of appointment of the need to begin and complete the reappointment process.
• Provide monthly performance reports including credentialing volume, cycle times, backlog, outstanding tasks, risk areas, and recommended process improvements to the Clinical Director.
• Support internal or external audits of credentialing files; provides files, documentation, and explanations as required. Assist in regulatory reviews (CMS or AAAHC) as needed.
• Follows the Privacy Act and service unit bylaws, rules, and regulations pertaining to confidentiality and protection of the material and maintenance of the files.
• Other duties as assigned.
  
  

Minimum Requirements

Education and Experience

• High School Diploma or GED required, Associate degree in Healthcare Administration, Business Administration, Health Information Management, or related field preferred.
• 2 years of experience in healthcare credentialing.

Knowledge, Skills, and Abilities

• Knowledge of provider credentialing and privileging standards.
• Knowledge and familiarity with electronic credentialing software programs, such as MD-staff.
• Ability to work independently in a remote environment.
• Familiarity with Accreditation Association for Ambulatory Health Care (AAAHC) accreditation standards.
• Demonstrated organizational skills and the ability to manage competing priorities.
• Strong written and verbal communication abilities.
• Proven ability to handle multiple credentialing files concurrently while meeting established deadlines.
• High level of accuracy and attention to detail.
• Proficiency in Microsoft Office Suite and other standard business applications.

Certifications/Licenses/Other

• Ability to obtain and maintain all client site and system badging and access requirements.

Physical Demands:

• Prolonged periods of computer work.
• Ability to review and manage electronic documentation for extended periods.
• Ability to communicate effectively via phone, email, and virtual meetings.

Apply online at our website: https://kikiktagruk.applicantpool.com/

Disclaimer:

This is not to be an exclusive list of all responsibilities, duties, and skills required of the person in this job. KIC is an Equal Opportunity Employer as to all protected groups, including protected veterans and individuals with disabilities. Pursuant to The Alaska Native Claims Settlement Act 43 U.S.C. Sec. 1601 et seq., and federal contractual requirements, Kikiktagruk Inupiat Corporation may legally grant certain preference in employment opportunities to KIC Shareholders and their Descendants. Successful candidates must adhere to KIC's Drug and Alcohol policy/testing requirements and may be required to pass a background and/or Motor Vehicle Records check. The salary range for this position is based on several factors, including relevant experience, education, skills, and current market conditions.