Credentialing Specialist I-CVO

J  o  b    D  e  s  c  r  i  p  t  i  o  n

          Joy                         Care                      Competence                    Respect

Position Summary

The Credentialing Specialist I-Credentials Verification Organization (CVO) will work remotely and will coordinate multiple projects (i.e. credentialing re/applications) at one time. Primary work functions utilize the credentialing database and both Microsoft Office (Word and Excel) and Google products. This role works closely with other team members to meet deadlines. The primary functions include Initial Application Credentialing, Reappointment Credentialing and Coordination of expirable documents.

High School Diploma or GED is required. 

Associate’s or Bachelor’s Degree Health Care Administration or related field is preferred. 

2 years clerical experience is required. 

2 years of experience in healthcare is preferred.

2 years of Hospital Credentialing or Payor Credentialing experience is preferred. 

Certified Provider Credentialing Specialist (CPCS) is preferred.

Aligns communication, people, processes, and resources to drive success.

Previous experience with relational database.

Intermediate User of Microsoft Office and Google products.

Ability to multitask.

Organizes work, sets priorities, and determines short or long-term goals and strategies to achieve them.

Expresses thoughts clearly, concisely, and effectively both verbally and in writing.

Self-starter, work without much supervision.

Initiate and coordinate the process for Primary Source Verification of Initial Applications to IL and WI Medical/AHP staffs.

Initiate and coordinate the process for Primary Source Verification of Reappointment Applications to IL and WI Medical/AHP staffs.

Communicate with Medical Staff Office Credentialing Specialist and/or Coordinators at Hospital sites re: status of Applications.

Coordinates the process to maintain current documents and/or verifications of expirables (IL and WI License, DEA, Board Certification, Malpractice COIs, Background checks, provider health requirements. certifications) etc. to ensure compliance with privileging, accreditation and regulatory standards.

Perform detailed and thorough review of applications, primary source verifications and sources provided.

Recognize potential discrepancies and adverse information, and independently investigate and validate information applications, primary source verifications, or other sources.

Complete all role-specific data entry assignments according to standards of work to maintain accurate practitioner data for feeds to downstream systems and capture production data.

Retrieve and follow-up timely on voice messages left.

Review and follow-up timely on emails received in the individual colleague work and central email inbox.

Attend weekly Medical Staff Services (MSS) Huddle meetings as scheduled, including any additional meetings as assigned/scheduled.

Attend regular or individual meetings in which updates about credentialing is necessary to collaboration with other departments, Medical Groups or other internal or external customers.

Possess the information, skill, and understanding of the work to be performed.  Actively participates in continuing education opportunities and maintains certifications, licensure as appropriate.

Abides by all safety requirements including demonstrating proper hand hygiene and wearing of Personal Protective Equipment (PPE), if applicable. 

Complies with all standards, policies and procedures including dress code, attendance and punctuality.  Attends required in-services and meetings and completes all mandatory competencies by deadline. Commits to keeping all patient, student or colleague information confidential and maintains ongoing communication and collaboration with team members. 

The purpose of this job description is to provide a summary of the major responsibilities performed by colleagues in this position. Colleagues may be requested to perform tasks other than those specifically presented in this job description.  Variances in job duties performed may exist between facilities, and colleagues may perform other related duties as assigned to meet the needs of the organization.

PHYSICAL, MENTAL AND ENVIRONMENTAL REQUIREMENTS

Physical, Mental and Environmental Requirements Category:

Administrative

Standing

X

Walking

X

Sitting

X

Lifting

X

20 lbs.

Carrying

X

20 lbs.

Pushing

X

20 lbs.

Pulling

X

20 lbs.

Climbing

X

Balancing

X

Stooping

X

Kneeling

X

Crouching

X

Crawling

X

Reaching

X

Use of Hands/Dexterity

X

Talking

X

Hearing

X

Eye/Hand/Foot Coordination

X

Extreme Cold

X

Extreme Heat

X

Humid

X

Wet

X

Noise

X

Hazards

X

Temperature Change

X

Atmospheric Conditions

X

Vibration

X

Other