Credentialing Specialist

Intermountain Healthcare; Salt Lake City (UT); On-site; USD 51,000 - 78,000; Full time

Benefits offered by this job

Generous benefits package

Job summary

Intermountain Healthcare is seeking a Credentialing Specialist to manage centralized verification activities, verify primary sources, and coordinate credentialing for hospitals, providers, and network participants.

Daily duties include reviewing provider data, handling credentialing applications, and maintaining records in our credentialing system. Strong communication, organization, and HIPAA compliance are essential for success in this role.

Qualifications

• Graduation from High School or equivalent, required.
• Knowledge of medical terminology required.
• Requires effective verbal and written communication skills and the ability to work well with a team.
• Intermediate level experience with Word, Excel, Adobe and OneNote; comfortable learning a sophisticated database program.

Responsibilities

• Facilitate all aspects of Primary Source Verification with accuracy and attention to detail.
• Review and ensure accuracy of provider information in credentialing software.
• Process initial credentialing and re-credentialing applications; capture primary source documentation.

Skills

Credentialing

Communication

Organizing

HIPAA

Data Entry

Customer Service

Critical Thinking

Multi-Tasking

Education

High School diploma or equivalent

Bachelor’s Degree (preferred)

Tools

Word

Excel

Adobe

OneNote

Database software

Job description

Job Description:The Credentialing Specialist (CS) is responsible for facilitating Intermountain Health’s centralized verification office (CVO) program and will serve as the primary credentialing liaison for hospitals, providers and/or network participating providers regarding credentialing services.Shift is Monday-Friday Business hours. No Holidays, Weekends, or Nights.Essential FunctionsThe CS will facilitate all aspects of Primary Source Verification program with accuracy and attention to detail. Including but not limited to written verification of applicants education and/or training, experience,They will review and ensure accuracy of provider information in credentialing softwaredirectly with the source for all applications.The CS processes initial credentialing and re-credentialing applications capturing primary sourcedocumentation in computer databases, prepares and keeps reports of credentialing activities likeaccreditation, membership, or facility privileges and makes sure the applications comply with applicable laws, regulations, procedures and policies.The CS needs to stay current on credentialing guidelines and make sure all records and applications are up to date and ready to be reviewed by the Hospital Medical Staff Office and Medical Staff CommitteesThe CS will have frequent contact with system-wide medical staff services professionals, administrators and practitioners.The CS must keep the Central Verification Office (CVO) Leaders apprised of problems or concerns and perform other work-related duties as assigned.Incorporate accreditation and regulatory standards requirements into medical staff activitiesWork on maintenance of provider records including expirable items and other necessary documents.SkillsMedical Staff CredentialingCommunicationOrganizingHealth Insurance Portability & Accountability Act (HIPAA)HospitalsHealth CareData EntryCustomer ServiceCritical ThinkingMulti-TaskingMinimum QualificationsRequires effective verbal and written communication skills and the ability to work well with a team.This position will utilize computer technology to perform job functions. Must have intermediate level experience with Word, Excel, Adobe and OneNote, and must be comfortable learning a sophisticated data base program.The incumbent must be able to work with a variety of health care professionals, able to function with minimal supervision, be self-motivated, keep confidences, have ability to adapt to frequent interruptions, have ability to solve problems and make decisions and possess organization and good communication skills.Working knowledge of TJC, NCQA standards as well as state and federal guidelines and requirementsGraduation from High School or equivalent, requiredKnowledge of medical terminology requiredPreferred QualificationsBachelor’s Degree from an accredited institution. Degree will be verified.Certified Provider Credentialing Specialist (CPCS) by the National Association of Medical Staff Services (NAMSS) orCertified Professional Medical Services Management (CPMSM) by the National Association of Medical Staff Services (NAMSS)Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within five (5) years of employment.Minimum of one year experience in administrative work.Experience as a medical staff coordinator, medical staff credentials specialist or privileging coordinator.One year experience in healthcare, legal or insurance environment.Physical RequirementsOngoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.Location:Key Bank TowerWork City:Salt Lake CityWork State:UtahScheduled Weekly Hours:40The hourly range for this position is listed below. Actual hourly rate dependent upon experience.$24.60 - $37.46We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.At Intermountain Health, we use the artificial intelligence (\"AI\") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.All positions subject to close without notice.