Credentialing Specialist

GI Alliance is seeking an experienced Medical Staff Coordinator.

Duties of this position include, but are not limited to, the following:

Position purpose

Manage, monitor, research, screen, and update all physician and allied health professionals' credentials as defined by GI Alliance policies, standard operating procedures and regulatory requirements in assigned region

Responsibilities/Duties/Functions/Tasks:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Assurance of timeliness and quality of credentialing and re-credentialing processes.
• Prepare provider credentialing and re-credentialing files for approval process for facility privileging requests.
• Tracks new applicants and reappointments to ensure that providers facility privileges/membership do not expire.
• Provide timely transmission of credentialing and approval information to hospitals and facilities
• Maintains on-site credentials files for physicians and ALPs in complete and current status
• Monitor and update provider and practitioner status and associated information as appropriate
• Provide accurate and informative status reports
• Continuously track and monitor credentialing status and credentials to ensure accuracy and identify re-credentialing needs
• Ensure compliance with GI Alliances policies and procedures as well as established regulatory and contractual requirements
• Maintain corporate provider contract files.
• Ensure provider scheduling is current for services being provided in the Ambulatory Surgery Centers or other facilities.
• Set up and maintains provider information in online credentialing databases and system.
• Tracks license and certification expirations for all providers to ensure timely renewals.
• Other duties as assigned

Qualifications

Education: High school diploma or equivalent. Associate Degree in Medical Staff Services Science, business or related field of study or an equivalent combination of training and experience preferred

Experience: Three (3) to five (5) years of credentialing experience preferred. Hospital experience is required.

Additional Preferred Qualifications:

• Knowledge of JCAHO credentialing requirements.
• Knowledge of credentialing process for allied health and medical staff applicants.
• Ability to obtain data from the Texas State Board and National Practitioner Data Bank.
• Familiar with the process of required medical staff meetings, duties of officers of the medical staff, and investigational process and reporting.
• Understanding of hospital credentialing / appointments
• Understanding of national accrediting entities (NCQA)
• Understanding of credentialing terminology
• Experience with primary source verification and associated credentialing sources

Performance Requirements:

• Strong presentation skills
• Excellent communication skills, both written and verbal
• Ability to work with physicians and non-physician providers in a fast-paced environment
• Proficient computer skills (Microsoft applications)
• Ability to multi-task and prioritize
• Ability to work independently
• Self-motivated with initiative; willingness to learn and adopt new strategies
• Strong sense of ethics.

GI Alliance is an Equal Opportunity Employer. We are committed to creating an inclusive, welcoming, and equitable work environment. Our company values and celebrates the diversity of our physicians, staff and patients. We firmly believe our service is greatly enriched by our diversity of thought, experience, perspective, culture, and background.

Please Note: All job offers are contingent on the successful completion of pre-employment criminal history check.

NOTE: ALL APPLICATIONS MUST BE COMPLETED IN FULL FOR CONSIDERATION.

No phone calls or agencies, please.

EEO/AA-M/F/disabled/protected veteran