System Credentialing Specialist

Job description

Your job is more than a job The System Credentialing Specialist is responsible for the System Verification Office (SVO) credentialing and re-credentialing of medical and allied staff performed on behalf of LCMC facilities. Supports departmental activities to ensure quality in conducting, maintaining, and communicating clinical staff credentialing and primary source verifications. Monitors statuses of the credentialing process for the medical and mid-level practitioners at LCMC Health. GENERAL DUTIES: Organizes and maintains provider data and files. Processes applications timely and ensures that quality benchmarks are met with regards to turnaround times, accuracy of information, other SVO and regulatory metrics, and in accordance with external requirements (accreditation, federal, and state). Executes credentialing application and data collection, application processing, primary source verification for all new applicants and applicants for re-credentialing. Assures applications are correct, complete, and resolves discrepancies in compliance with regulatory requirements. Provides and supports ongoing communication with SVO Leaders, especially in regards to risk/issues identified during the credentialing/recredentialing process. Follows all regulatory requirements related to the primary source verification process for medical/allied health staff and managed care compliance. Maintains awareness of The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Center for Medicare/Medicaid (CMS), and other regulatory compliance guidelines through LCMC SVO provided continuing education. Demonstrates excellent professional communication skills while interacting with colleagues, customer relations and MSO representatives, and leadership to collect missing information or resolve issues. Assures confidentiality is maintained at all times in all aspects of the SVO credentialing process and for practitioners. Performs daily office duties such as answering phones, filing, ordering supplies, etc. Other administrative tasks as assigned to assist the department. QUALIFICATIONS Required: High School Diploma/GED or equivalent Preferred: 2 years of relevant office experience and/or medical staff support service experience. LICENSES AND CERTIFICATIONS Preferred: Certified Professional Medical Staff Management (CPMSM) or Certified Professional Credentials Specialist (CPCS) by the National Association of Medical Staff Services (NAMSS) WORK SHIFT: Days (United States of America) LCMC Health is a community. Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary Your extras Deliver healthcare with heart. Give people a reason to smile. Put a little love in your work. Be honest and real, but with compassion. Bring some lagniappe into everything you do. Forget one-size-fits-all, think one-of-a-kind care. See opportunities, not problems – it’s all about perspective. Cheerlead ideas, differences, and each other. Love what makes you, you - because we do You are welcome here. LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. Simple things make the difference. 1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information. 2. To ensure quality care and service, we may use information on your application to verify your previous employment and background. 3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed. 4. To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.