Credentialing Specialist (On-site)

Orlando Health, Inc.; Orlando (FL); On-site; USD 52,000 - 75,000; Full time

Job summary

Orlando Health seeks a Credentialing Specialist to oversee credentialing, reappointment/recredentialing and delegated credentialing activities.

You will ensure compliance with accreditation standards, government agencies, and Orlando Health bylaws, while providing exceptional service to physicians and staff and maintaining accurate credentialing data.

Qualifications

• Knowledge of medical terminology.
• High school graduate or equivalent.
• Familiarity with credentialing data systems and Microsoft Word/Excel.

Responsibilities

• Performs credentialing and related functions per policy and procedures.
• Performs primary source verification in a timely, accurate manner.
• Enters credentialing data accurately into the credentialing database.
• Provides exceptional service to physicians and office staff and educates them on credentialing processes.
• Identifies trends and assists in performance-improvement actions; generates reports as needed.

Skills

Credentialing data systems

Microsoft Word/Excel

Medical terminology

Attention to detail

Education

High school graduate

Tools

Credentialing database

Job description

Position Summary

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond.

Benefits & Perks

All Inclusive Benefits (start day one)

• Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.

Forbes Recognizes Orlando Health as a Best-In-State Employer

• Forbes has named Orlando Health as one of America's Best-In-State Employers for 2024. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued.

Employee‑centric

• Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare

Role Overview

We are seeking a Credentialing Specialist responsible for the administration and coordination of all credentialing, reappointment/recredentialing and delegated credentialing activities. Ensures the needs of medical staff and managed care offices are met through efficient processes, assuring compliance to accreditation standards, government agencies, as well as Orlando Health bylaws, rules & regulations.

Responsibilities

Essential Functions

• Performs credentialing functions as outlined by Orlando Health management in accordance with established policy, procedures, and protocols.
• Performs timely and accurate primary source verification in addition to credentialing functions.
• Completes accurate and timely data entry of all credentialing activity into credentialing database.
• Provides exceptional customer service to physicians and physician office staff members as well as internal customers, such as members of other departments. Educates physicians and physician office staff on the credentialing process and maintains ongoing contact with these individuals throughout the process.
• Identifies trends and assists in the development of action plans for purpose of performance improvement. Evaluates processes in departmental policies & procedures and makes recommendations for changes to management. Develop and distribute reports as necessary utilizing credentialing database. Timely completion of all assigned duties.
• Maintains credentialing and reappointment/recredentialing files.
• Other duties as assigned
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions

• COMPLEXITY OF WORK: Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
• Knowledge of medical credentialing and privileging procedures and standards.
• Knowledge of accreditations/government agencies standards and Orlando Health bylaws, rules & regulations.
• Assumes responsibility for professional growth and development.

Qualifications

Education/Training

• High school graduate or equivalent.
• Knowledge of medical terminology.

Licensure/Certification

• None

Experience

• Three (3) years’ experience credentialing/privileging or;
• One (1) year of credentialing/privileging experience and/or two (2) years of clinical experience.
• Associate degree in business, health care, accounting or related field may be substituted for two (2) years of experience.
• Bachelor’s degree in health, business or related field may be substituted for three (3) years of experience.
• Proficiency in Microsoft Word, Excel, Internet and significant proficiency in credentialing data system.