Medical Staff Credentialing Specialist I

halifaxhealth; Daytona Beach (FL); On-site; USD 42,000 - 64,000; Full time

Job summary

Halifax Health in Daytona Beach is seeking a Medical Services Professional I to manage credentialing and privileging processes. You will determine eligibility, compile practitioner data, and present it for review by decision-making bodies to support medical staff appointments and reappointments.

You will perform primary source verification, monitor expirables, maintain the credentialing database, and ensure compliance with accreditation standards while collaborating with hospital leadership and

Qualifications

• Minimal High School Graduate; Associate degree preferred.
• Certified Credentialing Specialist (CPCS) preferred.
• Experience in provider credentialing and/or Medical Staff services a plus.

Responsibilities

• Conducts, participates in, and maintains credentialing and privileging.
• Determines applicant's initial eligibility for membership/participation.
• Compiles, evaluates, and presents practitioner-specific data collected for review by decision-making bodies.
• Analyzes applications and supporting documents for completeness; informs status and needs for additional information.
• Processes Medical Staff appointments, reappointments and expirables timely per policies and standards.
• Conducts, participates in, and maintains primary source verification.
• Obtains and evaluates information from primary sources.
• Identifies and resolves discrepancies and adverse information from sources.
• Verifies expirables using verification sources to ensure regulatory compliance.
• Provides responses to external queries regarding practitioners' status.
• Maintains credentialing database for accurate information accessible to stakeholders.
• Works with Hospital Managers, physicians, and staff professionally.
• Protect provider confidential information and documents.
• Communicate effectively with all contracts to achieve enrollment goals.
• Must comply with Halifax Health policies and procedures.

Skills

Customer service

Interpersonal skills

Communication

Professional presence

Team relationships

Education

Associate degree

Job description

Halifax Health in Daytona Beach is seeking a Medical Services Professional I to manage credentialing and privileging processes. You will determine eligibility, compile practitioner data, and present it for review by decision-making bodies to support medical staff appointments and reappointments.

You will perform primary source verification, monitor expirables, maintain the credentialing database, and ensure compliance with accreditation standards while collaborating with hospital leadership and