Job Description

Requisition Number
20-0021

Post Date
2/4/2020

Title
Credentialing Specialist

Employment Type
Full Time

Work Hours
Monday through Friday

Hours per week
40

City
Woodbury

State
MN

Description
Personal Growth. Expansion. Teamwork. Innovation. Be a part of a truly patient-first environment and an organization that cares about their employees.

Under the direction of the Director of Human Resources, the Credentialing position will administer the medical staff credentialing and reappointment process, along with Facility credentialing and DME as well as reporting additions, changes or deletions to do group and provider applications and assists the medical staff in supporting the organization’s mission, vision, and goals.

* Assist in the organizing and directing of a comprehensive and specialized credentialing program to assure continued accreditation by regulatory organizations.
* Establishes and administers the credentialing, reappointment, and privileging processes. Coordinates procurement of DE, licensure, and malpractice insurance information. Originates or collects and maintains appropriate records.
* Interpret, explain and follow all regulatory guidelines, including medical staff bylaws, fair hearing plan, rules and regulations and policies.
* Maintain systems to identify (and disseminate to others) medical staff members and their clinical privileges, prepare and maintain other related records and reports.
* Oversee the credentialing process for medical staff; work with medical staff leadership and clinical staff for the approval and ongoing review of these practitioners.
* Monitor and revise credentialing and privileging forms as needed. Ensure maintenance of medical staff files.
* Ensure that results of medical staff quality management findings are provided to appropriate review committees/ departments and maintained in a confidential file.
* Communicate medical staff information to appropriate departments.
* Demonstrate effective leadership skills and coordination of intra-department activities and inter-department integration. Assure the ongoing development and implementation of policies and procedures that guide and support the provision of services.
* Perform other related duties as assigned.

Summit Health ASO, provides administrative and clinical support to our full spectrum of orthopedic care services in our sub-specialty clinics, walk-in care at our OrthoQUICK clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert teams are part of the 900+ employees who partner to provide quality services and care designed to support a healthier, more active lifestyle.

Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.


Requirements

3 years payer credentialing and enrollment experience in a Business Office setting.

Must be familiar with medical terminology.


Application Instructions

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