Credentialing Specialist at Presbyterian Healthcare Services

Albuquerque, New Mexico, United States -

Full Time

Start Date

Immediate

Expiry Date

13 Feb, 26

Salary

27.25

Posted On

15 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Background Investigations, Primary Source Verification, Data Analysis, Medical Staff Management, Documentation, Licensure Verification, Professional Work History, Medical Malpractice History, On-boarding, Policy Compliance, Healthcare Providers, Application Processing, Focused Professional Practice Evaluations, Ongoing Professional Practice Evaluations, Privileging Eligibility Criteria

Industry

Hospitals and Health Care

Description

Overview Presbyterian is seeking a highly detail-oriented Credentialing Specialist to conduct comprehensive background investigations on physicians and healthcare providers seeking affiliation with our Albuquerque and regional facilities. This is a Full Time position - Exempt: No Job is based at Presbyterian Hospital Work hours: Days Ideal Candidate: Experience in hospital medical staff or manager care credentialing preferred. Qualifications High School Diploma. One (1) to three (3) years experience in hospital medical staff or managed care credentialing preferred. Certification or eligibility for certification as a Current certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred. Education Essential: High School Diploma or GED Responsibilities Analyze practitioner applications and/or requests to ensure that required documentation/information has been submitted in order to initiate the primary source verification processes Conducts primary source verification of applicants' education, licensure, professional work history, medical malpractice history for the purpose of determining competency and eligibility to be awarded membership and/or privileges Prepares processed files for review by appropriate members of medical staff leadership, including identification of information that may require additional investigation Utilizes appropriate tracking tools for the purpose of ensuring timely completion of applications Collects/analyzes data from various sources to include with initial and/or reappointment applications. Such data includes but is not limited to focused professional practice evaluations, ongoing professional practice evaluations, and privileging eligibility criteria Process other credentialing requests, as assigned, in accordance with established policies and procedures Responsible for on-boarding and/or orientation of new Medical Staff members, according to established policies and procedures Benefits About Presbyterian Healthcare Services Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits. The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives. As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $27.25/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

Responsibilities

The Credentialing Specialist will analyze practitioner applications to ensure required documentation is submitted and conduct primary source verification of applicants' qualifications. They will also prepare processed files for review and utilize tracking tools to ensure timely completion of applications.