Credentialing Specialist

CentraCare Health; Saint Cloud (MN); Hybrid; USD 31,000 - 47,000; Full time

Benefits offered by this job

Medical, dental, PTO

Tuition reimbursement

Job summary

CentraCare Health is seeking a Credentialing Specialist to prepare files for medical staff credentialing and privileging at St. Cloud Hospital. You will ensure accuracy in demographics, education, training, and employment verifications, working with clinicians and reviewers to resolve any issues.

The role follows Joint Commission and CMS standards, with a hybrid schedule (home and on-site). You will present files to the Credentials Committee and support policy improvements to daily operations.

Qualifications

• Associate degree or minimum of 3 years related experience.
• 2 years hospital and/or health care related experience required.
• NAMSS CPCS or CPMSM certification preferred.
• NAMSS membership preferred.
• Ability to work under pressure and meet deadlines.
• Strong verbal, written and interpersonal communication skills.

Responsibilities

• Prepare files for medical staff credentialing and privileging.
• Enter demographic, education, training, and employment verifications into the credentialing database with accuracy.
• Communicate with practitioners and hospital staff to clarify documents.
• Follow up on red flag issues in files in collaboration with reviewers.
• Present files at the Credentialing Committee for discussion and review.
• Assist in developing and improving credentialing policies and procedures.

Skills

Attention to detail

Under pressure

Regulatory knowledge

Strong communication

Healthcare experience

Team collaboration

Education

Associate Degree or related experience

Tools

MS Office

Job description

Find your purpose as a Credentialing Specialist with CentraCare. As a Credentialing Specialist you are responsible for preparing files for medical staff credentialing and privileging for CentraCare within the Clinical Partner Resource Office. The Credentialing Specialist plays a significant key role in assuring physicians and advanced practice providers are qualified to provide quality patient care within CentraCare. The position must accurately and efficiently completes medical staff credentialing, privileging and recredentialing processes in compliance with regulatory requirements, often under short timelines and shifting organizational priorities. In collaboration with physician and advanced practice provider reviewers, incumbent will follow-up on red flag issues in files. Presents files at system-wide Credentialing Committee for discussion and review. Must be highly detail oriented to complete accurate data entry of demographics, education, training, prior hospital affiliations and employment verifications into the credentialing database. Communicate with the practitioners and hospital staff by phone, fax, or email to facilitate the completion or clarification of credentialing and privileging documents. Engages in activities to develop and improve documents, policies and procedures to support day-to-day operations. This role ensures compliance with the Joint Commission, NCQA, Centers for Medicare/Medicaid Services, and other laws or Hospital policies.
Partners with the Supervisor of Credentialing, Recruitment, Contracting, Department and Medical Staff Leadership, St. Cloud Hospital Vice President of Medical Affairs, Credentials Committee members, members of the Medical Staff, Advanced Practice Providers, and the Medical Staff Office.

Schedule:

• Full-time 80 hours every 2 weeks
• Mon-Fri 8a-430p
• Hybrid position; at-home and onsite at the St. Cloud Hospital

Pay & Benefits:

• Starting pay is $22.85 per hour; exact wage determined by years of related experience.
  • Pay range: $22.85-$34.25 per hour
• Full time benefits: medical, dental, PTO, retirement, employee discounts and more!
• Tuition reimbursement and college grant programs available.

Qualifications:

• Associate Degree or minimum of 3 years equivalent experience required in lieu of education.
• 2 years hospital and/or Health Care related experience required.
• Certified Provider Credentialing Specialist CPCS or CPMSM certification through NAMSS preferred.
• MN Association Medical Staff Services (MAMSS) membership preferred.
• Must be able to work under pressure and meet deadlines.
• Self-motivated with the ability to work independently and to carry out assignments to completion within parameters of instructions given, established timeframes and standard accepted practices.
• Familiar with Joint Commission, NCQA, Centers for Medicare/Medicaid (CMS) and other accrediting agency standards.
• Demonstrate attention to detail, with a high degree of accuracy and organizational ability, have strong and effective verbal, written and interpersonal communication skills required.
• Knowledge in MS Office, office equipment, computer systems, and office administration.

CentraCare has made a commitment to diversity in its workforce. All individuals including, but not limited to, individuals with disabilities, are encouraged to apply. CentraCare is an EEO/AA employer.