Northwell Health Spclst Credentialing in Manhasset, New York

Req Number 002AYV

Job Description

Assures the credentialing of healthcare providers is conducted in accordance with organizational policies, operational procedures, and applicable governmental and regulatory agency regulations and standards. Performs activities associated with verification, tracking inquiries, and follow-up on problems which may delay completion of the file.

Responsibilities Include:

  • Obtains source verification of credentials in accordance with prevailing policies and procedures.

  • Tracks responses and follows-up on items not received within established cycle periods.

  • Reviews completed files with management in accordance with established schedules.

  • Maintains credential records.

  • Produces management reports regarding operations performance and/or provider credentialing status for internal management and external providers using the organization's verification services.

  • Adheres to operating policies and procedures including delivery of completed work and use of resources.

  • Initiates correspondence to providers, users, health plans and others as necessary to obtain requisite credentialing information.

  • Informs management regarding the status of departmental operations and provider credentialing issues of concern.

  • Performs related duties, as required.

Qualifications

  • Associates Degree in related field, required. Bachelor's Degree, preferred.

  • Certification as a Provider Credentialing Specialist (CPCS) from the National Association of Medical Staff Services, preferred.

  • Computer database skills and word-processing, required. Familiarity with Microsoft Office applications, desirable.

  • Demonstrated communication skills, required.

  • Excellent customer service skills and orientation.

  • High degree of organizational skills.