Credentialing Specialist - Full Time

Jefferson Health; Philadelphia (Philadelphia County); On-site; USD 60,000 - 90,000; Full time

Job summary

Jefferson Health in Philadelphia, PA, seeks a Credentialing Specialist to verify medical staff appointments, manage the credentialing database, and support committee approvals. The role interfaces with hospital departments and external parties to ensure complete and accurate credentialing information.

The ideal candidate has a bachelor’s degree in a related field and is willing to engage in process improvement initiatives. Knowledge of credentialing software and Microsoft Office is preferred.

Qualifications

• Bachelor’s degree in business, healthcare administration, human resource management, or related field.
• 2 years credentialing experience preferred but not required.
• CPCS/CPMSM preferred but not required.
• Knowledge of credentialing management software preferred but not required.
• Knowledge of Microsoft Office required.

Responsibilities

• Verifications for medical staff and allied health professionals' appointments, re-appointments, and privilege delineation.
• Maintain credentialing database for completeness and accuracy.
• Run reports on provider data accuracy and application status.
• Provide ad hoc support to credentialing committee for approvals and privileges.
• Communicate with internal and external customers for necessary information.

Skills

Attention to detail

Communication skills

Process improvement

Education

Bachelor’s degree in business/healthcare admin/HR

Tools

Credentialing software

Microsoft Office

Job description

Number of Positions In Requisition 1 Job Details . Job Description

ESSENTIAL FUNCTIONS

Responsible for verifications for medical staff and/or allied health professionals' initial appointments, re-appointments, and privilege delineation. Maintains credentialing database by ensuring that information entered is both complete and accurate. Runs various reports regarding: Accuracy of provider data Application status. Provides ad hoc support to assist with the credentialing committee’s approval, granting, and ultimately, release of privileges. Demonstrates willingness to be an active participant in process improvement initiatives and special projects to enhance credentialing procedures and outcomes. Communicate with internal and external customers to obtain or provide necessary information as it relates to verifications, malpractice claims, and any other pertinent information. Assists in compliance with accrediting and regulatory agencies (i.e., The Joint Commission) regarding credentialing by maintaining a working knowledge of statutes and laws. Acts as a liaison between hospital clinical departments, practitioner applicants, and other external parties.

ADDITIONAL QUALIFICATIONS

Demonstrates attention to detail in all aspects of work. Forward-thinking mindset to anticipate and address potential challenges or opportunities. Strong ability to think critically and problem-solve effectively. Willingness to be an active participant in process improvement initiatives and special projects to enhance credentialing procedures and outcomes.

JOB REQUIREMENTS

• Bachelor’s degree in business, healthcare administration, human resource management, or another related field required.
• 2 years of prior credentialing experience preferred but not required.
• Certified Provider Credentialing Specialist (CPCS), or Certified Professional Medical Services Management (CPMSM) is preferred but not required.
• Knowledge of credentialing management software is preferred but not required.
• Knowledge of Microsoft Office required.

Work Shift Workday Day (United States of America) Worker Sub Type Regular Employee Entity Thomas Jefferson University Hospitals, Inc. Primary Location Address 111 S 11th Street, Philadelphia, Pennsylvania, United States of America Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research.

Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students.

Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region.

Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.

Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.

All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

In keeping with Jefferson's Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education. With a long standing history, Jefferson has been advancing the medical field from the heart of Center City Philadelphia for nearly 200 years. Our Mission, We Improve Lives, expands to every corner of the organization. From our weekly farmer’s market, to our new Jefferson Accelerator Zone for innovation, our employees’ passion for the community is evident by the daily gestures towards our patients, students and each other.