Credentialing Specialist

Faith-based family health care center seeking a full-time Credentialing Specialist to join our growing administrative team! The Credentialing Specialist will be responsible for ensuring compliance with HRSA regulations for the medical and dental staff of the center. This role will also maintain provider credentialing with all insurance carriers and privileges with rounding sites. PLEASE NOTE THAT THIS POSITION IS AN IN-OFFICE POSITION AND REQUIRES THE INCUMBENT TO REPORT ON-SITE.

Please visit www.elfhcc.com to learn more about our company and mission to provide quality healthcare for all.

**COVID and Influenza vaccines are required**

QUALIFICATIONS

• High school diploma or equivalent. Associate's Degree in business administration, or health related field preferred.
• One year of credentialing and privileging experience in a medical setting is required.
• Must have working knowledge of the credentialing process -initial appointment, privilege delineation, focused and ongoing monitoring and reappointment.
• Ability to interpret and apply regulations (The Joint Commission and HRSA).
• Excellent computer skills using Microsoft Word and Excel and web-based programs; exceptional internet research skills.
• Excellent writing and editorial skills and exhibit a high degree of confidentiality.
• Must possess superb organizational skills and be familiar with HRSA and JCAHO standards.

KEY JOB RESPONSIBILITIES

• Review, complete and monitor application for provider credentialing
• Contact medical facilities, licensing agencies and insurance carriers to complete credentialing and re- credentialing applications
• Secure and maintain provider privileges to ELCHCC, hospitals and insurance carriers
• Track new /acquisition providers for licensure, privileges and credentialing
• Database maintenance: address changes, CAQH updates, and Carrier file maintenance.
• Compliance with company policies and procedures, local, state and federal government regulations as well as HIPAA Guidelines
• Verify competence, medical and/or professional education, residency, internships, fellowships, additional formal training, relevant board certifications, health care affiliations, work history, military experiences, professional references, licensure and certifications, DEA certificates, malpractice coverage and privileges the applicant is requesting Querying the National Practitioner Data Bank as appropriate
• Organizing and maintaining credentials files in the medical staff office Present completed files to Medical Director or Dental Director for approval; prepare file to go to board for final approval.

COMPENSATION:

Salary range commensurate with education and experience.

BENEFITS:

At East Liberty Family Health Care Center, we offer an exceptional benefits package including Medical, Dental, Vision, Life Insurance, Retirement, Employee Assistance Program, Holiday pay, Paid sick/vacation, and supplemental benefit options.

East Liberty Family, Health Care Center, does not discriminate by race, sex, color, creed, religion, disability, veteran status, genetic information, pregnancy, or national origin in any manner. East Liberty Family, Healthcare Center, is an Equal Opportunity Employer. EOE/AA/M/D/F/H/V