Credentialing Specialist

CREDENTIALING SPECIALIST

"We encourage Military Veterans and Military Spouses to apply"

SITE OF SERVICE:

· Fort Bliss, TX

POSITION QUALIFICATION/REQUIREMENTS:

· Degree: Certificate

· Education: Possess a high school diploma or equivalent General Educational Development (GED) certificate, plus a minimum of one year at university or junior/community college.

· Experience: Possess a minimum of two years of experience within the last four years working in a hospital, insurance network, or managed care environment where at least 50% of the time was spent focused on verifying and maintaining the credentials of licensed, registered, and/or certified medical personnel, including but not limited to physicians, advanced practice registered nurses, physician assistants, therapists, etc.

· Cardiac Certification(s): Basic Life Support (BLS) from the American Heart Association or American Red Cross

· U.S. Citizenship: HCWs performing under this contract shall be U.S. citizens.

· English Language Requirement: The Contractor shall ensure that all HCWs providing services under this contract are able to read, write, and speak English well enough to effectively communicate.

· Physical Capability: HCWs shall be physically capable of standing and/or sitting for extended periods of time and physically capable of performing all services.

CORE DUTIES:

· The main mission is to conduct mobilization/deployment, demobilization/re-deployment and/or soldier readiness for all service members, civilians, and contractors to deploy/re-deploy from the theater of operations.

· Coordinate and communicate activities with the WBAMC Credentialing Office.

· Perform primary and secondary source verifications of credentials according to departmental policy.

· Establish and update practitioner's credentials files (PCF) and provider activity files (PAF) on providers going through the process. Audits files for completed information upon submission, requests missing data from providers. Ensure accuracy and completeness of files via application of appropriate regulations. Ensure that designated HCPs receive and maintain a valid, current license. Maintain liaison with educational institutions, state licensing agencies, hospitals, professional associations, specialty boards, and governmental staff offices. Ensure provision of a clear, written delineation of clinical privileges to each HCP.

· Notify Network Services Representatives when unable to obtain required documentation.

· Prepare files for presentation to the Chief Medical Officer and Credentialing Committee.

HOURS:

Routine operational hours are 7:30 a.m. to 4:00 or 4:30 p.m. but can vary as dictated by the mission to medically screen all personnel scheduled to be processed on that day or as directed by the medical facility. Although shifts are generally 40 hours per week, the possibility exists for longer shifts, evening shifts, and weekend shifts services. This includes a 30 or 60-minute lunch break

SPECIAL REQUIREMENTS/SKILLS

Must be comfortable in a fast-paced, dynamic environment. Must be able and willing to reprioritize on short notice and work on multiple simultaneous projects. Flexible and able to work with various personalities. Team work skills required. Time management skills required. The ability to meet deadlines in a deadline intensive environment is essential. High level of adaptability and willingness to embrace change in a fast-paced, demanding environment.

LUKE is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration from employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age or any other characteristic protected by law.

Links:

To learn more about LUKE, please visit our website at: http://www.lukestaffing.com