Verification Specialist, Full-Time, Day Shift, Bethlehem

St. Luke’s Health Network, Inc.; Shimer (PA); On-site; USD 65,000 - 78,000; Full time

Job summary

St. Luke's University Health Network is seeking a Verification Specialist to verify information submitted by physicians and advanced practitioners applying for Medical Staff privileges, ensuring compliance with regulatory and accrediting requirements.

You will enter provider information into the credentialing system, post credentialing data on the Physician Web, collaborate with Medical Staff and leadership, and monitor for timely completion of credentials.

Qualifications

• Experience with personal computers and Microsoft Office is required.
• Strong customer service skills.
• Excellent verbal and written communication skills.
• Detail- and service oriented.

Responsibilities

• Performs credentialing verification for initial, temporary and reappointment applications for Physicians and Advanced Practitioners.
• Verifies that provider credentials comply with regulatory and accrediting requirements.
• Collaborates with Medical Staff and leadership to ensure credentialing standards are met and timely completion is achieved.
• Conducts data analysis of credential files and maintains an accurate practitioner database.
• Ensures timely verification of provider credentials and privileges per policies and procedures.
• Posts credentialing information on the Physician Web for APS and Credentialing Committees approval.
• Develops and maintains collaborative agreements for advanced practitioners.
• Accurately enters provider information into the Credentialing System
• Monitors addition of new providers to physician groups and related agreements with state departments.
• Documents, tracks and resolves provider issues.

Job description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Verification Specialist is responsible for the verification of information submitted by a Physician or an Advanced Practitioner applying for Medical Staff privileges at St. Luke's University Health Network facilities. The Specialist ensures that compiled data is in in compliance with all regulatory and accrediting requirements. Ensures that all information for Medical Staff appointment is complete and accurate. Prepares and submits completed information for Medical Staff approval.

JOB DUTIES AND RESPONSIBILITIES

• Performs activities related to the Network credential verification process for initial, temporary and reappointment applications for Physicians and Advanced Practitioners.
• Verifies credentials of providers are in compliance with regulatory and accrediting requirements.
• Collaborates with Medical Staff and leadership to ensure credentialing and processing standards are met. Reaches out to Medical Staff as necessary for timely completion of credentialing information.
• Conducts data analysis of assigned credentials files and documents ensuring an accurate and current practitioner database utilizing the Credentialing software.
• Ensures accurate and timely verification of provider credentials and privileges according to established policies and procedures.
• Posts accurate credentialing information on the Physician Web as documentation is completed for Allied Professional Staff (APS) and Credentialing Committees approval.
• Develops and maintains a collaborative agreement for each advanced practitioner.
• Accurately enters provider information into the Credentialing System
• Monitors when new providers are added to a physician group practice, and that provider is added to the corresponding collaborative/supervising agreement and sent to the appropriate state department.
• Documents, tracks and resolves provider issues.

PHYSICAL AND SENSORY REQUIREMENTS

Sitting for up to eight (8) hours a day, three (3) hours at a time, including extensive use of computer terminal and telephone. Standing and walking as necessary. Pushing and pulling file carts, moving of hands as it relates to computer work and filing. Occasional stoops and bends, squats, kneeling and reaching above the shoulder level. Hearing as it relates to normal and telephone conversation. Seeing as it relates to general, near and far vision.

EDUCATION

High School Education

TRAINING AND EXPERIENCE

• Experience with personal computers and Microsoft Office is required.
• Strong customer service skills.
• Excellent verbal and written communication skills.
• Detail and service oriented.

St. Luke's University Health Network is an Equal Opportunity Employer.