Responsible for maintaining regular cooperation and compliance with all regulatory, accrediting and membership-based organization such as Det Norske Veritas (DNV), The Joint Commission (TJC), and National Committee for Quality Assurance (NCQA). Responsible for performing various credentialing processes in relation to physicians, advance practice, and various healthcare professionals. To include but not limited to processing applications and reappointment paperwork, verifying for full completeness and accuracy. Collect and process significant verification and accreditation information, and thus maintain and update accurate databases for both practitioners and facilities. Databases include pertinent education, training experience, and licensure content for all professional medical staff and advance practice professionals. Must prepare internal records for auditing, as well as maintain effective communication with all practitioners to ensure records are up-to-date and consistent.
Objective: Primary goal of the Credentials Specialist is to assist in ensuring healthcare professionals and services meet all established federal and state standards, as well as National Committee for Quality Assurance (NCQA) standards.
1. Must have Associates degree in healthcare administration (Bachelor’s preferred) or five-year’s experience in hospital healthcare setting.
2. Must have 24 consecutive months of experience in Medical Staff credentialing. Certified Provider Credentialing Specialist (CPCS) certification required one-year of employment or after 36- consecutive months of experience. Certification MUST be obtained.
3. Must have knowledge of physician enrollment as well as some billing / coding experience.
4. Must have Medico-legal experience.
5. Strong communication and written skill required.
6. Computer skills necessary (Microsoft Word, Power Point, Excel, and Adobe).
7. Medical Terminology required.
8. Ability to collaborate successfully with physicians and managers.
9. Remarkable organizational and planning skills required.
10. Ability to work independently; and strong attention to detail is essential.
11. Exceptional secretarial skills required.
12. Ability to type 45 wpm.
Telecommuting is allowed.
Additional Salary Information: Benefits include Medical, Dental, Vision, life insurance, long-term disability, retirement and flex spending. Third party supplemental plans available in addition to EAP, gym membership reimbursement and a generous paid time off plan.
Internal Number: 4174
About Ridgecrest Regional Hospital
Ridgecrest Regional Hospital is an independent acute care hospital located in California's High Desert region at the base of the Southern Nevada mountains. RRH offers a comprehensive compendium of services for the residents of the Southern Sierra Region and provide competitive pay and benefits for our employees.