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Credentialing Technician

Indian Health Service
Ridge, SD Full Time
POSTED ON 12/10/2024
AVAILABLE BEFORE 8/13/2025
This position serves as a Credentialing Technician who is responsible for the management of all aspects of the credentialing and privileging program for the medical staff of the Pine Ridge Service Unit. The position reports to the Medical Staff Coordinator.

Qualifications:

This announcement is being re-advertised as Open Until Filled in order to solicit additional applications. Applicants who previously applied, need not reapply unless they would like to update their application. Applications should be submitted ASAP to ensure you will be considered for this position. The first "cut-off" for review of applications will be 10 working days from the opening date, which is 08/28/2024, and every 10 working days thereafter unless the position has already been filled before the next cut-off date.

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.

MINIMUM QUALIFICATIONS:

Your resume must demonstrate the following education and/or experience as outlined below for the grade level(s) you are applying to. Any specialized experience must be equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the tasks as identified.

GS-05: One (1) year of specialized experience equivalent to at least the GS-04 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Performing administrative support functions using automated data systems and a variety of software packages to accomplish a wide range of duties in coordinating medical staff information and privileging for the medical facility; initiates and processes applications for medical staff membership and clinical privileges; initiates background research on all applicants; uses computer software programs to manage medical staff credentialing and privileging processes. Observes and enforces privacy and confidentiality regulations and laws in a health care setting. Or four (4) years of education above high school. Or a combination of education and experience that when combined fully meet the minimum qualifications for the position. Only education in excess of the first 60 semester hours is creditable toward meeting the specialized experience requirement.

GS-06: One (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Interpreting and applying provider credentialing and privileging procedures and regulations; processing documents related to medical credentialing and privileging activities; reviewing records for completeness and to obtain data to verify privileging qualifications/education; using computer database and software to enter, manipulate, retrieve and report on medical credentialing and privileging activities; compiling, abstracting and analyzing credentialing data; and providing medical credentialing and privileging guidance to staff as necessary. Observes and enforces privacy and confidentiality regulations and laws in a health care setting.

GS-07: One (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Independently being responsible for the effective, accurate, and timely management of healthcare professional applications for credentialing and privileging determinations in accordance with federal, state, and department procedures; monitors and follows up on status of applications; assists with background investigations; validates discrepancies; and maintains effective relationships with providers; compiles and maintains a variety of reports and files; administers regulatory compliance and quality assurance for all medical and professional staff. Observes and enforces privacy and confidentiality regulations and laws in a health care setting.

Time In Grade
Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).

You must meet all qualification requirements within 30 days of the respective cut-off date for application review.

Responsibilities:

  • Provides completed information packages for committee review.
  • Initiates and processes application for medical staff membership and clinical privileges.
  • Coordinates medical staff information and privileging for Pine Ridge Service Unit.
  • Review findings of internal and external administrative reviews and audits.
  • Interprets and analyzes reports to modify or correct operations which are necessary to maintain compliance.

Salary : $39,576

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