Credentialing Specialist — Healthcare Verifications & Compliance

Thomas Jefferson University & Jefferson Health; Philadelphia (Philadelphia County); On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

Medical insurance

Tuition assistance

Retirement plans

Job summary

Thomas Jefferson University Hospitals, Inc. is seeking a Credentialing Specialist to verify qualifications, manage initial appointments, and support privilege delineation for medical staff and allied health professionals.

This role requires meticulous data management, reporting on application status, and collaboration with clinical departments and external parties to ensure regulatory compliance and timely credentialing decisions.

Qualifications

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

Responsibilities

• Verifications for medical staff and allied health professionals' initial appointments, re-appointments, and privilege delineation.
• Maintains credentialing database for completeness and accuracy.
• Runs reports on provider data accuracy and application status.
• Provides ad hoc support to assist credentialing committee with approvals, grants, and release of privileges.
• Participates in process improvement initiatives to enhance credentialing procedures and outcomes.
• Communicates with internal and external customers to obtain or provide necessary information related to verifications and malpractice claims.
• Assists in compliance with accrediting bodies (e.g., The Joint Commission) regarding credentialing.
• Acts as a liaison between hospital clinical departments, practitioner applicants, and external parties.

Skills

Attention to detail

Forward-thinking

Critical thinking

Process improvement

Education

Bachelor’s degree in business, healthcare administration, HR, or related field

Tools

Credentialing software

Microsoft Office

Job description

Thomas Jefferson University Hospitals, Inc. is seeking a Credentialing Specialist to verify qualifications, manage initial appointments, and support privilege delineation for medical staff and allied health professionals.

This role requires meticulous data management, reporting on application status, and collaboration with clinical departments and external parties to ensure regulatory compliance and timely credentialing decisions.