Credentialing Specialist-LCMC

Presbyterian Healthcare Services; Ruidoso (NM); On-site; USD 25,251 - 37,539; Part time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Disability Insurance

Life Insurance

Job summary

Presbyterian Healthcare Services is seeking a credentialing professional to support affiliations with PHS-Albuquerque and regional facilities. The role includes thorough primary source verification of licensure, education, postgraduate training, board certification, and malpractice history, plus maintaining credentialing data to meet regulatory standards.

The position is part-time and located at Lincoln County Medical Center in Ruidoso, with daytime shifts.

Qualifications

• High School Diploma required or equivalent.
• 1–3 years hospital medical staff or managed care credentialing experience preferred.
• Certification as CPMSM or CPCS preferred.

Responsibilities

• Analyze practitioner applications to initiate primary source verification.
• Conduct primary source verification of education, licensure, work history and malpractice history.
• Prepare files for medical staff leadership review and identify information needing further investigation.
• Utilize tracking tools to ensure timely completion of applications.
• Collect and analyze data for initial and reappointment applications.
• Process credentialing requests per policies and procedures.
• Support onboarding/orientation of new Medical Staff members.

Skills

Credentialing

Attention to detail

Communication

Education

High School Diploma

CPMSM/CPCS certification preferred

Job description

Compensation Pay Range

Minimum Offer $18.33
Maximum Offer $27.25

Location

211 Sudderth Dr Ruidoso, NM 88345-6002

Summary

Conducts thorough background investigation on physicians and other providers applying for affiliation with PHS -Albuquerque and regional facilities. This includes reviewing applications for completeness, conducting primary source verification of licensure, education, post‑graduate clinical training, board certification, disciplinary actions and other professional sanctions, malpractice history, and peer assessment of current competence. Identifies issues that require additional investigation and/or follow‑up. Responsible for collecting and processing reappointments of Medical Staff members and ensuring they are completed within specified time periods. Processes requests for updated privileges, status changes. Maintains a variety of tickler systems to ensure that processing is timely and meets state and federal regulatory requirements and accreditation standards as they apply to Credentialing. Maintains accurate data in the credentialing database which is accessed by multiple business units within the organization. Type of Opportunity: Part time. Job Exempt: No. Job is based: Lincoln County Medical Center. Work Shift: Days (United States of America).

Responsibilities

• Analyze practitioner applications and/or requests to ensure that required documentation/information has been submitted in order to initiate the primary source verification processes.
• Conduct primary source verification of applicants' education, licensure, professional work history, medical malpractice history for the purpose of determining competency and eligibility to be awarded membership and/or privileges.
• Prepare processed files for review by appropriate members of medical staff leadership, including identification of information that may require additional investigation.
• Utilize appropriate tracking tools for the purpose of ensuring timely completion of applications.
• Collect and analyze data from various sources to include with initial and/or reappointment applications. Such data includes but is not limited to focused professional practice evaluations, ongoing professional practice evaluations, and privileging eligibility criteria.
• Process other credentialing requests, as assigned, in accordance with established policies and procedures.
• Responsible for on‑boarding and/or orientation of new Medical Staff members, according to established policies and procedures.

Qualifications

• High School Diploma.
• One to three years experience in hospital medical staff or managed care credentialing preferred.
• Certification or eligibility for certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred.

Benefits

All benefits‑eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short‑term and long‑term disability, group term life insurance and other optional voluntary benefits.

AA/EOE/VET/DISABLED. PHS is a drug‑free and tobacco‑free employer with smoke free campuses.