Under the direction of the Senior Director of Credentialing Verification Office with daily activities supervised by the Credentialing Manager, this position performs all duties for initial and recredentialing file processing per NCQA, The Joint Commission, state and federal regulations and Medical Staff By-Laws.
Responsibilities include, but are not limited to:
REQUIRED KNOWLEDGE & SKILLS:
· Strong organizational, problem solving, and prioritization skills as demonstrated by the successful and timely completion of assignments.
· Excellent verbal and written communication skills, ability to interact with all levels of personnel
· Keen attention to detail
· Experience working in a team-oriented, collaborative and matrix environment
· Working knowledge of Microsoft Office, Skype and other software used in daily work
· Education: Bachelor's degree or equivalent education and experience
Three or more years of credentialing experience in a medical staff services department or managed care plan desired.
Experience with Initial and Reappointment file processing according to NCQA and TJC standards.
National Certified Provider Credentialing Specialist Certification preferred.