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Credentialing Specialist I
Torrance Memorial Torrance, CA
$49k-61k (estimate)
Full Time | Hospital 1 Week Ago
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Torrance Memorial is Hiring a Credentialing Specialist I Near Torrance, CA

DescriptionThe Credentialing Specialist performs the initial and reappointment credentialing process, and ensures compliance with the Medical Staff credentialing requirements. In addition, this position is responsible for making recommendations on improvements to the credentialing policies and procedures, based on experience and/or evolving regulatory requirements (i.e. Federal, State and Joint Commission). The Credentialing Specialist will serve as the focal point for credentialing process, distribute and receive applications and reappointment, analyze applications and reappointment and perform primary source verification, prepare files for review, monitor and document credentialing efforts, serve as knowledge expert on credentialing, monitor credentialing status of applicant, continuously improve the credentialing process, and perform general administrative support tasks as needed. Major challenges of this position include managing a high volume of work with critical deadlines, analyzing complicated applications for thorough and current information, and staying abreast of frequently changing internal policies and procedures and external standards and requirements.
Core Competencies
  • Assembles and provides application and reappointment applications to physicians, independent and dependent health practitioners and ensure correct procedure have been applied to eligibility criteria, as defined by the medical staff (ie Medical Staff Bylaws, Rules and Regulations, Policies/Procedures).
  • Applies credentialing standards and techniques to process initial request for medical staff privileges.
  • Processes all medical staff applications in accordance with Medical Staff Bylaws and procedures.
  • Assesses requests for clinical privileges by applying credentialing criteria.
  • Ensures that physicians are not presented to the medical staff for evaluation of clinical privileges to perform procedures that they have not been trained to perform or do not have current clinical competence to perform.
  • Enters all applicant data into computer.
  • Maintains a log of mailed applications, including return date.
  • Prepares files of physicians requesting privileges for review by the Credentials Committee, clinical department and other appropriate committees.
  • Assists Medical Staff Coordinators in review of the application/credential files with attention to issues of concern (red flags) or questions that require detailed evaluation by the department chief.
  • Assists with training of Medical Staff Coordinators in use of credentialing software, including development of automated forms, and other necessary documentation with development of spreadsheets as needed.
  • Prepares a report for the Board of Trustees of medical staff applicants, resignations, deaths and physicians in violation of medical staff bylaws, etc
  • Prepares and distributes monthly staff status changes to all departments within Torrance Memorial.
  • Prepares correspondence to inform physicians of decisions of Credentials Committee, Executive Committee and the Board of Trustees.
  • Assists Vice President with notification of proper state/federal agencies of reportable actions taken against an applicant as needed.
  • Maintains current Department Rules and Regulations and privilege cards (forms) for assigned departments in conjunction with the initial application process.
  • Maintains equipment and work area per department policies and procedures.
  • Assists with orientation and training of new employees and volunteers as assigned.
  • Utilizes appropriate and effective communication and problem solving skills in all interpersonal interactions.
ExperienceAdditional InformationMinimum of two years of experience in medical staff services, appropriate medical center clerical experience, or administrative clerical experience. Medical terminology. Proficiency with PC-based software.
Compensation Range$30.24 - $46.20 / Hour

Job Summary

JOB TYPE

Full Time

INDUSTRY

Hospital

SALARY

$49k-61k (estimate)

POST DATE

06/13/2024

EXPIRATION DATE

07/13/2024

WEBSITE

torrancememorial.org

HEADQUARTERS

TORRANCE, CA

SIZE

3,000 - 7,500

FOUNDED

1925

TYPE

NGO/NPO/NFP/Organization/Association

CEO

CRAIG LEACH

REVENUE

$500M - $1B

INDUSTRY

Hospital

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About Torrance Memorial

Torrance Memorial is a nonprofit medical center that offers alcohol and drug treatment, maternal child health and emergency care services.

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The job skills required for Credentialing Specialist I include Problem Solving, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing Specialist I. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing Specialist I. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Credentialing Specialist I positions, which can be used as a reference in future career path planning. As a Credentialing Specialist I, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist I. You can explore the career advancement for a Credentialing Specialist I below and select your interested title to get hiring information.

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If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Credentialing Specialist job description and responsibilities

A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.

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A credentialing specialist can have certificates that will prove useful to their field.

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Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.

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Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.

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Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.

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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Credentialing Specialist jobs

Credentialing specialists can often find work with a high school diploma or the equivalent.

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Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.

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While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.

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Make Use Of Advanced Software For Monitoring.

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Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.

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Step 3: View the best colleges and universities for Credentialing Specialist.

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