Credentialing Specialist
US-NM-Albuquerque
Careers (External)
Req #: 47252
Type: Full Time
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Overview: Presbyterian is seeking a highly detail-oriented Credentialing Specialist to conduct comprehensive background investigations on physicians and healthcare providers seeking affiliation with our Albuquerque and regional facilities. Key Responsibilities: * Review credentialing applications for accuracy and completeness. * Perform primary source verification of licensure, education, post-graduate clinical training, board certification, disciplinary history, malpractice records, and peer assessments of competency. * Manage the reappointment process for medical staff, ensuring timely completion within specified deadlines. * Process requests for updated privileges and status changes. Qualifications & Skills: * Strong analytical and organizational skills. * Attention to detail and ability to work within regulatory requirements. * Experience in healthcare credentialing preferred. Join our team and play a crucial role in maintaining the integrity and excellence of our medical staff. How you belong matters here. We value our employees' differences and find strength in the diversity of our team and community. At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members. Why Join Us * Full Time - Exempt: No * Job is based at Presbyterian Hospital * Work hours: Days * Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees. Responsibilities: * Analyze practitioner applications and/or requests to ensure that required documentation/information has been submitted in order to initiate the primary source verification processes * Conducts primary source verification of applicants' education, licensure, professional work history, medical malpractice history for the purpose of determining competency and eligibility to be awarded membership and/or privileges * Prepares processed files for review by appropriate members of medical staff leadership, including identification of information that may require additional investigation * Utilizes appropriate tracking tools for the purpose of ensuring timely completion of applications * Collects/analyzes data from various sources to include with initial and/or reappointment applications. Such data includes but is not limited to focused professional practice evaluations, ongoing professional practice evaluations, and privileging eligibility criteria * Process other credentialing requests, as assigned, in accordance with established policies and procedures * Responsible for on-boarding and/or orientation of new Medical Staff members, according to established policies and procedures Qualifications: * High School Diploma * One (1) to three (3) years experience in hospital medical staff or managed care credentialing preferred. * Certification or eligibility for certification as a Current certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred. Education Essential: High School Diploma or GED
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