CREDENTIALING SPECIALIST -

UNM Hospital; Albuquerque (NM); On-site; USD 26,560 - 32,965; Full time

Job summary

A health sciences facility in Albuquerque seeks a CREDENTIALING SPECIALIST to coordinate and manage the credentialing and privileging processes for medical providers. Successful candidates will have a high school diploma or GED and at least 2 years of related experience. Responsibilities include reviewing applications for completeness, conducting research on provider credentials, and facilitating committee meetings. The position offers a full-time role with a salary range of $19.28 to $23.93 per hour.

Qualifications

• High School diploma or GED equivalent required.
• 2 years of directly related experience in credentialing preferred.

Responsibilities

• Coordinate and administer the credentialing and privileging process.
• Research and verify credentials of medical staff.
• Advise on compliance issues regarding regulations.
• Schedule and facilitate credentialing committee meetings.
• Provide consultations on credentialing practices.
• Monitor expenditures for administrative functions.
• Participate in educational programs for professional growth.

Skills

Attention to detail

Knowledge of regulatory compliance

Research skills

Administrative skills

Education

High School or GED Equivalent

Job description

Join to apply for the CREDENTIALING SPECIALIST role at UNM Hospital.

Minimum Offer: $19.28/hr.  Maximum Offer: $23.93/hr.

Department: Provider Network Development.  FTE: 1.00.  Full Time.  Shift: Days.

Position Summary

Coordinate, administer, and check all aspects of the credentialing and privileging process for physicians, professional staff providers, and network practitioners within all operational entities of the Health Sciences Center. Initiate and coordinate the reappointment process for existing providers within assigned areas; ensure accuracy and completeness of all documentation; serve as initial point of contact to client faculty and staff on day-to-day credentialing issues. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.

Detailed Responsibilities

• CREDENTIALING - Review and screen initial medical staff credentialing applications for completeness, accuracy, and compliance with federal, state, local and University regulations, guidelines, policies, and standards
• CREDENTIALING - Perform external research and conduct verification of all applicant licensure, education and training, relevant past employment, and affiliations; assess compliance with risk exposure criteria, and advise management on eligibility for temporary privileges consideration
• RESEARCH - Interpret federal, state, local, and government/insurance agency regulation and guidelines, as well as University and Medical Staff Affairs policies for client faculty and staff; advise providers, management, and administrators on compliance issues as appropriate
• MEETINGS - Schedule, coordinate agenda for, and facilitate various committees charged with approving credentials and reappointments of medical providers within client areas; provide support and follow up on matters arising from committee meetings
• CREDENTIALING - Provide on-site consultations across HSC to credentialing and privileging practices and services; prepare and conduct monthly NCC credentialing committee meeting and provide updates on new policies and procedures
• COORDINATION - Interface with providers and students, client departments, internal agencies, and all related external health care agencies on day-to-day credentialing and privileging issues as they arise
• ADMINISTRATION - Perform various administrative functions such as monitoring expenditures and preparing reports and correspondence; may participate in a variety of research projects to develop service plans; may propose changes to program policies and procedures
• DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops

Qualifications

Education:
High School or GED Equivalent.

Experience:
2 years directly related experience.

Credentials:
Not Applicable/Not Required.

Physical Conditions

Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Essential Conditions

Working conditions: No or min hazard, physical risk, office environment.