Credentialing Specialist

11000 Central Office; United States; Remote; USD 33,000 - 51,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

Intermountain Health is seeking a Credentialing Specialist to manage its centralized verification office and serve as the main liaison for hospitals, providers, and network participants. The role follows standard business hours with potential for remote options within the Intermountain footprint.

You will handle primary source verification, credentialing and re-credentialing processes, maintain records, and ensure all documentation meets TJC/NCQA and state/federal guidelines while coordinating

Qualifications

• Requires effective verbal and written communication skills and the ability to work well with a team.
• Must have intermediate level experience with Word, Excel, Adobe and OneNote, and be comfortable learning a sophisticated database program.
• Knowledge of TJC, NCQA standards and state/federal guidelines is required as well as general medical terminology.

Responsibilities

• Facilitate Primary Source Verification with accuracy and attention to detail.
• Review and ensure accuracy of provider information in credentialing software.
• Process initial and re-credentialing applications with primary source documentation.
• Maintain records and reports of credentialing activities and ensure compliance with laws and policies.
• Coordinate with Hospital Medical Staff Office and committees as needed.

Skills

Medical Staff Credentialing

Communication

Organizing

HIPAA

Data Entry

Customer Service

Critical Thinking

Multi-Tasking

Education

Bachelor's Degree NAMSS CPCS CPMSM

CPCS NAMSS

CPMSM NAMSS

HS Diploma or Equivalent

Tools

Word

Excel

Adobe

OneNote

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. While a candidate living within the Intermountain footprint (ID, UT, NV, CO, WY & MT), we are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Virginia Vermont, Washington. Please note that Video phone screens and interview(s) through Microsoft Teams will be required as well for fully remote position.

Essential Functions

The 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 software directly with the source for all applications. The CS processes initial credentialing and re-credentialing applications capturing primary source documentation in computer databases, prepares and keeps reports of credentialing activities like accreditation, 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 Committees The 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 activities Work on maintenance of provider records including expirable items and other necessary documents.

Skills

Medical Staff Credentialing Communication Organizing Health Insurance Portability & Accountability Act (HIPAA) Hospitals Health Care Data Entry Customer Service Critical Thinking Multi-Tasking

Minimum Qualifications

Requires 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 requirements Graduation from High School or equivalent, required Knowledge of medical terminology required

Preferred Qualifications

Bachelor’s Degree from an accredited institution. Degree will be verified. Certified Provider Credentialing Specialist (CPCs) by the National Association of Medical Staff Services (NAMSS) or Certified 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 Requirements

Ongoing 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

Location: Key Bank Tower Work City: Salt Lake City Work State: Utah Scheduled Weekly Hours: 40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $24.60 - $37.46

Benefits

We 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. Learn more about our comprehensive benefits package here.

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.

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services.

Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery.

Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment.

The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.

All positions subject to close without notice.

To find out more about us, head to our career site here.