Credentialing Quality Assurance Specialist Details

CHG Healthcare - Fort Lauderdale, FL

Employment Type : Full-Time

Healthcareâs helping hand.:

CHG shook things up in 1979 by inventing the locum tenens staffing model. We connect doctors with patients who need their care. As the largest physician staffing firm in America, our providers treat millions of patients each year.

Our industry is growing and demand is high. This means you’ll have plenty of opportunities to grow and develop in your career. Keeping healthcare healthy can be as fun as it is rewarding.

This position is responsible for the internal credentialing process function and the file review and approval for the Internal Credentialing Team. The Quality Assurance Specialist will be responsible to ensure all files approved are complete with essential documentation in accordance to CHG Healthcare Services applicable standards, corporate policies and procedures, mission, core values and

department expectations. Your role::
  • Scrutinizes provider applications and resumes for consistency and accuracy
  • Receive, triage & process quality evaluations & continuous queries
  • Consults with MSS Coordinators with questions concerning file/QM review
  • Interfaces with Medical Staff Service (MSS) teams, operational teams, and others as needed to deliver/share information about file review status
  • Reviews and approves provider files, consulting with QM Managers as necessary, to ensure compliance with most current credentialing policy and procedures
  • Maintains current knowledge of applicable practitioner credentialing standards.
  • Assist team members with credentialing process function
  • Serves as backup for QA Supervisor in all capacities
  • Assist Medical Staff Services Managers with other duties as assigned
  • Contributes to a positive culture
  • Contributes to ongoing process improvement
Your qualifications::
  • Excellent customer service skills and ability to foster strong relationships with others
  • Accurately types 35 wpm
  • Ability to articulate information and concepts convincingly
  • Proven time management skills focusing on urgent and overlapping deadlines
  • Experience with MS Word, Excel and/or database applications
  • Works independently with little supervision
  • Excellent teamwork skills
  • Demonstrates strong critical thinking skills and problem-solving skills
  • Close attention to details and ability to use audit process techniques
  • Excellent written and oral communication skills
Experience & Education:
  • Two years' work experience in a support position involving customer interaction and task completion
  • Three years' demonstrated ability to successfully credential multiple physician specialty files
  • High school diploma or equivalent
  • Familiarity with the medical field and/or medical terminology
  • College Education
Abilities:
  • Effectively manage large amounts of information and documentation
  • Prioritize efficiently
  • Strong organizational skills and attention to detail
  • Strong analytical and problem-solving abilities
  • Excellent time management skills focusing on urgent deadlines
  • Ability to persuade, influence and educate others in a positive and professional manner
In return, we offer::
  • Competitive pay
  • Flexible work schedules - including work from home options available
  • 401 (k) retirement plan
  • Healthcare coverage with corporate wellness program
  • Free health center and health coaching for employees and dependents
  • 18 days of PTO your first year and paid holidays
  • Up to 16 hours of paid volunteer time off
  • Award-winning training and development programs
#Associate How to Get Started: To have your resume reviewed by Talent Acquisition, click “Apply” at the top of the screen.
We are an Affirmative Action/Equal Opportunity Employer Veterans/Disabled We are an at-will employer

Posted on : 2 years ago