Government Credentialing Specialist

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

The Government Credentialing Specialist reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities:

• Initiate, verify, examine, and maintain the confidential credentials process for all professional applicants to NM (physicians, psychologists, advanced practice nurses, physician assistants, and designated clinical fellows).
• Examine application for completeness and all required documentation.
• Examine information reported for missing data elements.
• Conduct follow-up with applicant on identified adverse elements.
• Identify key issues in core credentials data.
• Report identified adverse information and unresolved questions to credentials compliance coordinator.
• Identify all practice locations for each applicant for his/her lifetime work history.
• Determine when investigation and credentials process is complete by comparing and contrasting file to requirements and verifying that all documentation meets standards.
• Identify and flag time-sensitive items for reverification.
• Generate profile and reports.
• Submit recommendation for final follow-up to the lead credentialing specialist and/or manager prior to administrative review process.
• Maintain accurate and current credentials database for all applicants.
• Record all credentials information immediately upon receipt.
• Monitor and track application status and credentials process.
• At all times, any department staff member must be able to access an applicants electronic record and determine current status.
• Provide first contact and customer service to professional applicants and NU/NMG credentialing staff.

Required:

• 3 years credentialing experience.
• Detail-oriented, organized, demonstrates good judgment, self-motivated, ability to multi-task, and work independently.
• Extensive experience and knowledge of PC app lications, including database management (Access) and Microsoft Office.
• Excellent interpersonal, customer service, and communication skills (oral and written).
• Develop and maintain effective working relationships with diverse professionals, medical staff officers, department staff, and other customers.
• Knowledge of HIPAA standards.
• Work in a fast-paced environment; meet ongoing schedules and deadlines.
• Recognize and maturely handle a variety of situations, often of a confidential or urgent nature.

Preferred:

• Bachelors degree
• 3-5 years credentialing experience.
• Experience in a university-affiliated teaching hospital.

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.