Offer summary

Qualifications:

A 4-year degree is required., 5-7 years of experience in credentialing or privileging is preferred., Knowledge of credentialing software, ideally Verity Credential Stream., Strong communication skills and understanding of regulatory standards..

Key responsibilities:

Manage provider credentialing and re-credentialing processes.

Verify and maintain accurate provider files and credentials.

Support medical staff governance meetings and document management.

Respond to inquiries and ensure compliance with accreditation standards.

Job description

Job Details

Job Location: CBO Office - Atlanta, GA

Position Type: Full Time

Education Level: 4 Year Degree

Salary Range: Undisclosed

Travel Percentage: As needed for business requirements.

Job Category: Compliance

Description

GENERAL SUMMARY OF DUTIES: The Medical Staff Services Specialist is responsible for key functions related to maintaining accurate and compliant provider files in Verity Credential Stream, credentialing and re-credentialing for gastroenterology and anesthesia providers, and supporting medical staff governance meetings and documents (by-laws, rules, regulations, etc.).

REPORTS TO: General Counsel and Compliance Officer

RESPONSIBILITIES:
Duties may include but are not limited to:

Initiate and support the practitioner application process by sending, receiving, and analyzing practitioner documents and data import to determine completeness in preparation for the credential’s verification process.
Responsible for gathering and verifying highly confidential and sensitive health care practitioner credentials consistent with departmental guidelines and accreditation standards.
Manages key credentialing functions such as APP/CAA pairings, primary source verification, background screenings, etc. to secure and maintain privileges.
Efficiently performs all aspects of verification, including initial appointment and reappointment, to ensure current credentials and timely handoff and/or review and approval of practitioner files.
Respond to all practitioner, client health plan and internal inquiries in a timely manner.
Monitor expiring licensure, board, and professional certifications and other expirable documents within the prescribed timeframe to maintain complete and compliant provider files.
Responsible for accurate enter data to assure the integrity of credentialing information in applicable database(s).
Professionally interfaces with providers to gather information, as needed.
Collaborate with participating clients, department managers and /or external agencies to facilitate and ensure smooth hand-off during the credentialing process.
Creates and maintains professional working relationships with hospital medical staff offices and partners to evaluate and grant privileges for AGA providers.
Use critical thinking skills to conduct follow-up with individual practitioners and internal and external entities to resolve discrepancies identified during the credentialing process.
Follow credentialing, accreditation, and regulatory standards.
Participate in accreditation/certification surveys, where needed.
Perform other duties as assigned to meet the goals and objectives of the organization.

REQUIRED EDUCATION, SKILLS & EXPERIENCE:
High School diploma or GED, healthcare or related field and 5-7 years of progressive experience in credentialing/privileging strongly preferred. Working knowledge of credentialing/privileging software preferred, ideally Verity Credential Stream. Knowledgeable in all aspects of provider credentialing/privileging, including knowledge of regulatory & compliance standards, credentialing processes, and medical staff privileging. Must be proficient in Microsoft Office suite. Strong communication skills from team level to peer level to C-suite level required.

PHYSICAL/MENTAL/ENVIRONMENTAL DEMANDS
Requires sitting and standing associated with a normal office environment. Travel (local and nationwide) as business needs dictate.

DRUG FREE WORKPLACE
United Digestive is a drug free workplace. All offers of employment are contingent upon passing a pre-employment drug screening.

EQUAL OPPORTUNITY EMPLOYER
United Digestive MSO Parent, LLC is an Equal Opportunity Employer and does not discriminate based on race, religion, gender, color or national origin in its employment practices.