MEDICAL STAFF SERVICES CREDENTIALING SPECIALIST, FULL TIME DAYS
Carson City, Nevada
Employer: Carson Tahoe Regional Healthcare
Industry: Medical Staff Support Services
Salary: Competitive
Job type: Full-Time
Description
US:NV:Carson City Medical Staff Support Services
Full Time
About Carson Tahoe Health
CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5 th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
Summary
Under direction of the Senior Credentialing Specialist, the Credentialing Specialist participates in Department activities to ensure quality in conducting, maintaining, and communicating physician credentialing, privileging, and primary source verifications. This position collaborates with others to advance the quality of practitioners and patient safety of the facility.
Responsibilities
• Conducts, participates in and maintains credentialing and privileging • Determines applicant`s initial eligibility for membership/participation • Analyzes application and supporting documents for completeness and informs the practitioner of the application status, including the need for any additional information • Performs initial and reappointment/re-credentialing for eligible practitioners • Conducts, participates in and maintains primary source verification • Recognizes, investigates and validates discrepancies and adverse information obtained from the application, primary source verifications or other sources. • Verifies and documents expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards. • Provides responses to external queries regarding practitioners` status. • Uniformly applies clearly defined credentialing or privileging processes to all practitioners/providers. • Audits, assesses, procures, implements, effectively utilizes and maintains practitioner/provider credentialing process and information systems by analyzing the needs and resources of medical services/credentialing. • Maintains credentialing database to ensure that accurate and current information is available to all stakeholders. • Assists the Medical Staff office in providing all credentialing, privileging and meeting support activities for Carson Tahoe Health and Medical Staff leadership. • Implements the physician enrollment and credentialing process for providers across the Carson Tahoe Health System. Maintain the timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials. • Coordinates credentialing data needed for enrollment, contracting, and other related purposes. Credentialing data includes but is not limited to the medical degree, Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, malpractice insurance and state insurance form. • Works closely with Physicians to obtain missing documentation for providers pertaining to provider enrollment. Obtains appropriate authorized signatures and follows up with the carriers on documentation submitted. • Performs other related duties as assigned.
Qualifications
• Required o High School Diploma or equivalent o One year experience in a position with responsibilities relating to Medical Staff credentialing o Understanding of Medical Staff Governance and Peer review processes o Knowledge of medical insurance carrier policies and procedures, State and Federal rules and regulations • Preferred o Credentialing experience in Acute Healthcare setting o Certified Provider Credentialing Specialist (CPCS) certification through NAMSS o Notary Public for the State of Nevada
Top 5 Reasons to Live in Carson City, Nevada
Our Benefits
US:NV:Carson City Medical Staff Support Services
Full Time
About Carson Tahoe Health
CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5 th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
Summary
Under direction of the Senior Credentialing Specialist, the Credentialing Specialist participates in Department activities to ensure quality in conducting, maintaining, and communicating physician credentialing, privileging, and primary source verifications. This position collaborates with others to advance the quality of practitioners and patient safety of the facility.
Responsibilities
• Conducts, participates in and maintains credentialing and privileging • Determines applicant`s initial eligibility for membership/participation • Analyzes application and supporting documents for completeness and informs the practitioner of the application status, including the need for any additional information • Performs initial and reappointment/re-credentialing for eligible practitioners • Conducts, participates in and maintains primary source verification • Recognizes, investigates and validates discrepancies and adverse information obtained from the application, primary source verifications or other sources. • Verifies and documents expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards. • Provides responses to external queries regarding practitioners` status. • Uniformly applies clearly defined credentialing or privileging processes to all practitioners/providers. • Audits, assesses, procures, implements, effectively utilizes and maintains practitioner/provider credentialing process and information systems by analyzing the needs and resources of medical services/credentialing. • Maintains credentialing database to ensure that accurate and current information is available to all stakeholders. • Assists the Medical Staff office in providing all credentialing, privileging and meeting support activities for Carson Tahoe Health and Medical Staff leadership. • Implements the physician enrollment and credentialing process for providers across the Carson Tahoe Health System. Maintain the timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials. • Coordinates credentialing data needed for enrollment, contracting, and other related purposes. Credentialing data includes but is not limited to the medical degree, Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, malpractice insurance and state insurance form. • Works closely with Physicians to obtain missing documentation for providers pertaining to provider enrollment. Obtains appropriate authorized signatures and follows up with the carriers on documentation submitted. • Performs other related duties as assigned.
Qualifications
• Required o High School Diploma or equivalent o One year experience in a position with responsibilities relating to Medical Staff credentialing o Understanding of Medical Staff Governance and Peer review processes o Knowledge of medical insurance carrier policies and procedures, State and Federal rules and regulations • Preferred o Credentialing experience in Acute Healthcare setting o Certified Provider Credentialing Specialist (CPCS) certification through NAMSS o Notary Public for the State of Nevada
Top 5 Reasons to Live in Carson City, Nevada
- Live, work and play in one of the most beautiful regions in the world
- Enjoy an array of outdoor activities world class skiing, golf, camping, mountain biking, hiking, water skiing, kayaking, hunting and fishing
- Just next door is Beautiful Lake Tahoe
- We are minutes from Reno known as the 'biggest little city in the world' - Fine dining, nightlife, shopping and home to the University of Nevada Reno.
- Family friendly atmosphere with affordable housing & excellent school system
Our Benefits
- No State Income Tax
- Medical, Dental, Vision, FSA, Telehealth
- Paid Time Off, Mental Health, and Volunteer Days
- 100% Vested 401K & Roth with Company Contribution
- Tuition Reimbursement
- Referral Bonuses
- On Site Education & Certification Programs
- Base Wage Increases for Relevant Advanced Degrees
- Free Calm App Subscription
Created: 2024-09-01
Reference: 1838678
Country: United States
State: Nevada
City: Carson City
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