Job Description

Position:  Credentialing Specialist
Location: New York

Job Description: The Credentialing Specialist assumes responsibility for overseeing and executing the comprehensive process of provider credentialing, encompassing initial appointments, reappointments, credential audits, and clinical privileging. This role pertains to Medical Staff, Allied Health Professionals, and other providers, adhering strictly to corporate policies, procedures, and hospital bylaws. Utilization of MDStaff credentialing software is central to conducting and monitoring all credentialing and background checks, ensuring stringent adherence to accuracy and data integrity standards. This position demands adeptness in interpreting and ensuring compliance with pertinent accrediting and regulatory agencies' requirements while fostering an in-depth understanding and updated knowledge of statutes and laws related to credentialing.

Responsibilities:

• Oversee and manage the complete lifecycle of provider credentialing, including initial appointments, reappointments, audits, and clinical privileging processes.
• Execute credentialing and background checks using MDStaff software, ensuring meticulous attention to detail and maintaining data accuracy.
• Interpret and ensure compliance with relevant accrediting and regulatory agencies' standards and guidelines.
• Develop and sustain a proficient understanding of statutes and laws governing credentialing, ensuring adherence to legal and regulatory requirements.
• Collaborate effectively with the Medical Staff Office, Allied Health Professionals, and other relevant departments to facilitate seamless credentialing procedures.
• Uphold and enforce adherence to corporate policies, procedures, and hospital bylaws concerning provider credentialing.

Requirements:

• Bachelor's degree in Healthcare Administration, Business Management, or related field preferred.
• Previous experience in healthcare credentialing and privileging processes is essential.
• Proficiency in utilizing MDStaff or similar credentialing software applications.
• Strong understanding of accrediting and regulatory agency standards (e.g., Joint Commission, NCQA, CMS).
• Exceptional attention to detail and commitment to maintaining data accuracy and integrity.
• Ability to interpret and apply legal and regulatory requirements related to credentialing.
• Excellent communication skills, both written and verbal, with the ability to collaborate effectively with various stakeholders.
• This position requires on-site work; remote work is not available.

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