Credentialing Specialist

Planned Systems International; Forest Park, Northern (GA, KY); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Competitive benefits package

401(k) retirement plan

Tuition reimbursement

Job summary

Planned Systems Interantional with ProClivIT is seeking a Credentialing Specialist to provide centralized credentialing and privileging services to the USAR Command, including initial entry credentialing and maintenance of files.

The role involves verifying credentials for physicians and other professionals, managing data in CCQAS/JCCQAS, and preparing documentation for review by the Centralized Credentials Privileging Board. Strong MS Office skills and excellent communication are required.

Qualifications

• Two plus years of credentialing experience with DoD using CCQAS/JCCQAS.
• Experience documenting and maintaining credentialing records and files.
• Knowledge of verifying credentials and maintaining data files.

Responsibilities

• Manage verification process for healthcare professionals across licensure databases.
• Implement USAR policies to ensure credentialing operations comply with standards.
• Complete verifications and build credential review files for Centralized Credentials Privileging Board.

Skills

Credentialing

MS Office

Verbal & written communication

Education

High School Diploma or equivalent

Bachelor's Degree in Healthcare or related field

Tools

CCQAS/JCCQAS

Job description

Overview

Planned Systems Interantional with ProClivIT is seeking a Credentialing Specialist toprovide centralized credentialing and privileging services and support to the United States Army Reserve (USAR) Command with initial entry credentialing, maintenance of credentialing and privileging, and support the Centralized Credentials Privileging Board’s review of completed credentials and privileging files.

Essential Functions and Job Responsibilities

Individuals will be responsible for managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health). This includes reviewing applications for completion, verification of state licensure, collecting information contained in the national physician data bank, collecting information from the Health Care Integrity and Protection Databank, collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals. Job duties will specifically also include:

• Implementing USAR policies and standards to ensure that credentialing operations are complying.
• Working with applicants and USAR staff to support and enhance credentialing functions.
• Completing verifications and ensuring that the organization and staff are in accordance with USAR directives and industry trends and standard credentialing procedures.
• Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results.
• Generating and emailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing.
• Data entry into CCQAS as the official system of record.
• Prepare and maintain reports of employees based on accreditation, education, facility privileges, experience, membership and licensure, ensuring all employee information meets federal, state and local guidelines.
• Maintain regular written and verbal correspondence with agencies, hospitals, malpractice carriers and medical review boards.

Minimum Requirements

• Two plus years of credentialing experience with the DoD utilizing CCQAS/ JCCQAS.
• Two years of experience in performing the following functions: conduct administrative and record keeping aspects of the operation of engineering or technical projects / programs; apply knowledge of office management, methods and procedures in producing and maintaining documentation, correspondence, records or directives; work in regard to matters such as project / program progress and status documentation, budget, finance property accounting or personnel.
• Knowledgeable of requirements for verifying doctors' or other types of practitioners' credentials, processing the information and maintaining information data files.
• Have knowledge, and the maintain awareness, of current American Accreditation Healthcare Commission standards.
• Proficient with Microsoft Office software, to include, but not limited to Word, PowerPoint, Excel, Outlook, etc.
• Excellent verbal and written communication skills, including excellent customer relationship skill sets.
• High School Diploma or Equivalent

Desired Qualifications

• Bachelor's Degree in Healthcare, or related field. An equivalent combination of education, certification, and relevant experience may be considered.
• Experience in Quality Assurance preferred.
• Experience in the DOD credentials process preferred

Company Benefits

PSI offers full-time, benefits eligible employees a competitive total compensation package that includes paid leave, and options for employer sponsored group medical, dental, vision, short-term and long-term disability, life insurance, AD&D coverage, legal services, identity theft, and accident insurance. Flexible spending account and health saving account options offer pre-tax savings for qualified medical, dental, and vision expenses. The company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested. We invest in the professional growth of our employees through professional courses, certifications, and tuition reimbursement programs.

EEO Commitment

It is company policy to promote equal employment opportunities. All personnel decisions, including, but not limited to, recruiting, hiring, training, promotion, compensation, benefits, and termination, are made without regard to race, color, religion, age, sex, sexual orientation, pregnancy, gender identity, genetic information, national origin, citizenship status, veteran status, protected veteran status, disability, or any other characteristic protected by applicable federal, state, or local law.