Facility Credentialing Specialist II

Overview

: USAP is seeking a dedicated and knowledgeable Facility Credentialing Specialist II to join our Maitland, FL team. The Facility Credentialing Specialist II maintains accurate records of providers’ credentials. Processes providers’ applications for privileges and reappointments and monitors licensure renewal activity for Physicians, CRNA’s, APN’s, and PA’s.

Job Highlights

:

• Processes initial applications and reappointments for hospitals, surgical centers, and managed care entities for assigned divisions.
• Maintains a complete file of the provider’s licensure and credentials. Monitors renewals of licensure and forwards copies of licensure to facilities as renewals are received.
• Maintains and updates a credentialing database, inclusive of demographic and licensure information.
• Maintains and updates continuing medical education/ACLS credits and other training requirements.
• Maintains and updates curriculum vitae/profiles for each provider.
• Maintains correspondence files and credentialing archival files.
• Performs other credentialing duties as requested.
• Adhere to all company policies and procedures.
• Perform other duties as assigned.

REPORTING TO THIS POSITION: No direct reports

JOB REQUIREMENTS (Knowledge, Skills and Abilities):

• Knowledge of the organization’s policies, procedures, and systems.
• Skilled in computer applications including MS Word, MS Excel, database administration, and scanning applications.
• Knowledge of NCQA and/or JCAHO Accreditation standards.
• Skilled in verbal and written communications.
• Knowledgeable in Federal and State Regulation on Confidentiality; and Peer Review Guidelines.
• Ability to work effectively with staff, physicians, and external customers.
• Ability to work independently with limited supervision.
• Communicate well with the public.

Qualifications

:

• High School graduate or equivalent. A.S. or B.S. degree in business administration or health care related field preferred.
• CPMSC/CPCS Certification preferred.
• Three to Five years minimum experience in Credentialing.