Credentialing And Privileging Specialist

Highmark Health

Working At Home, PA, United States
Base: $21.32 - $34.39; bonus/equity: not specified...
Investigation and documentation of practitioner credentials
Verification of practitioner background
Understanding of regulatory requirements
This job coordinates and implements the credentialing and privileging activities within the Credentialing and Privileging Office to include appointment, reappointment and ongoing verification activities of the Medical Staff and Allied Health Professional Staff of AHN entities

Job Summary

  • This job coordinates and implements the credentialing and privileging activities within the Credentialing and Privileging Office to include appointment, reappointment and ongoing verification activities of the Medical Staff and Allied Health Professional Staff of AHN entities.
  • Responsible for the investigation and documentation of practitioner credentials, utilizing specialized knowledge to obtain verification of all aspects of a practitioner's background, training and past practice.
  • Understands credentialing and privileging requirements of the Department of Health, Joint Commission, NCQA, URAC and other governmental requirements, and performs in accordance with these standards.

Matching Summary

This job coordinates and implements the credentialing and privileging activities within the Credentialing and Privileging Office to include appointment, reappointment and ongoing verification activities of the Medical Staff and Allied Health Professional Staff of AHN entities.

Salary

Base: $21.32 - $34.39; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • investigation and documentation of practitioner credentials
  • verification of practitioner background
  • understanding of regulatory requirements
  • maintaining accurate documentation
  • handling customer questions and complaints

Nice-to-have

  • adherence to ethical and legal standards
  • compliance with HIPAA
  • data security guidelines

Key Requirements

  • 3 years general office administration
  • Associate's Degree preferred
  • 3 years physician credentialing and privileging preferred
  • 1 year customer service preferred
  • CPCS or CPMSM certification preferred

Work Rights

Not specified

Tailored Resume

Cover Letter