Credentialing Specialist
Orlando
Position Summary:
We are seeking a Credentialing Specialist responsible for the administration and coordination of all credentialing, reappointment/recredentialing and delegated credentialing activities. Ensures the needs of medical staff and managed care offices are met through efficient processes, assuring compliance to accreditation standards, government agencies, as well as Orlando Health bylaws, rules & regulations.
Schedule
Monday - Friday 8am-4:30pm
Location
1335 Sligh Blvd 3rd FL
Orlando, FL 32806
Responsibilities:
Essential Functions- Performs credentialing functions as outlined by Orlando Health management in accordance with established policy, procedures, and protocols.
- Performs timely and accurate primary source verification in addition to credentialing functions.
- Completes accurate and timely data entry of all credentialing activity into credentialing database.
- Provides exceptional customer service to physicians and physician office staff members as well as internal customers, such as members of other departments. Educates physicians and physician office staff on the credentialing process and maintains ongoing contact with these individuals throughout the process.
- Identifies trends and assists in the development of action plans for purpose of performance improvement. Evaluates processes in departmental policies & procedures and makes recommendations for changes to management. Develop and distribute reports as necessary utilizing credentialing database. Timely completion of all assigned duties.
- Maintains credentialing and reappointment/recredentialing files.
- Other duties as assigned
- Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards.
- Maintains compliance with all Orlando Health policies and procedures.
- COMPLEXITY OF WORK: Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
- Knowledge of medical credentialing and privileging procedures and standards.
- Knowledge of accreditations/government agencies standards and Orlando Health bylaws, rules & regulations.
- Assumes responsibility for professional growth and development.
About Orlando Health:
Orlando Health, headquartered in Orlando, Florida, is a not-for-profit healthcare organization with $9.2 billion of assets under management that serves the southeastern United States and Puerto Rico. Founded more than 100 years ago, the healthcare system is recognized around the world for Central Florida’s only pediatric and adult Level I Trauma program as well as the only state-accredited Level II Adult Trauma Center in Pinellas County.It is the home of the nation’s largest neonatal intensive care unit under one roof, the only system in the southeast to offer open fetal surgery to repair the most severe forms of spina bifida, the site of an Olympic athlete training facility and operator of one of the largest and highest performing clinically integrated networks in the region.
Orlando Health has pioneered life-changing medical research and its Graduate Medical Education program hosts more than 350 residents and fellows. The 3,888-bed system includes 29 hospitals and emergency departments – 24 of which are currently operational with five coming soon.
Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions.“Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.
Qualifications:
Education/Training- High school graduate or equivalent.
- Knowledge of medical terminology.
None.
Experience
Three (3) years’ experience credentialing/privileging or;- One (1) year of credentialing/privileging experience and/or two (2) years of clinical experience.
- Associate degree in business, health care, accounting or related field may be substituted for two (2) years of experience.
- Bachelor’s degree in health, business or related field may be substituted for three (3) years of experience.
- Proficiency in Microsoft Word, Excel, Internet, and significant proficiency in credentialing data system.
Orlando
information, visit our company homepage Rotech.com
JOB INFORMATION:
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