Credentialing Specialist – PT or FT, Seattle, WA
The Proliance Surgeons’ corporate office, located in Seattle, is looking for a part-time or full-time Credentialing Specialist to join their team.
The primary role of the employee is to manage the daily workflow of credentialing and recredentialing applications with proficiency, accuracy and timeliness. This role participates in all aspects of initial credentialing, recredentialing and on-going monitoring for physicians and practitioners under established policy.
Essential Duties and Responsibilities:
- Maintain comprehensive knowledge of credentialing standards, primary source verification process and the accepted sources and methods required to obtain necessary documentation
- Work closely with Director of Risk and Compliance to evaluate adequacy and information quality for effective and comprehensive peer review decision-making
- Maintain on-going Monitoring Program per NCQA and CMS standards
- Assist in annual review process for delegates to ensure timely credentialing pre-assessments, annual audits, file review, analysis, and written evaluation and ongoing follow up as applicable
- Maintain basic knowledge of credentialing delegation; requirements, oversight and industry standard
- Responsible for set up and maintenance of all credentialing files in an organized manner and closely monitor information collection and is cognizant of all information received and pursues additional information if necessary. Includes analyzing information per policy and NCQA & CMS standards
- Responsible for tracking the credentialing expiration elements of all facilities, physicians and practitioners with accuracy and timeliness
- Monitors system reporting for accuracy and assists in the maintenance of system identification for staggered credential renewals
- Works with other staff to streamline and improve processes related to credentialing and provider data
- Other job duties and projects as assigned
Education and Experience:
- Ability to edit material and ensure correct punctuation, spelling and grammar
- Medical Terminology
- Proficiency in software applications to include data base integrity; and use of menu driven word processing and spreadsheet applications
- Experience with credentialing software is preferred, but not required
How to Apply:
If interested in applying, please email your cover letter and resume to email@example.com.