Credentialing Specialist

Department:
Scotland Memorial Hospital - Patient Financial Services

Status:
Full time

Shift:
1st (United States of America)

Schedule Details/Additional Information:

Job Description:
1.Performs the credentialing and privileging process in accordance with federal and state mandates as well as with criteria defined by Scotland Healthcare 's compliance policy, in a complete and accurate manner.
2.Tracks and follows up on physicians initial application/onboarding processes and reappointment application by performing primary source verification, preparing agency correspondence, and tracking responses within the organizations database
3.Works with necessary individuals- including physicians, other professional staff and their office to acquire necessary materials and information for provider certification and licensure
4.Serves as credentialing contact for employed physicians and advanced practice professionals. Monitors employed physicians and advanced practice professionals' credentials including, but not limited to state licensure, board certification, and hospital affiliation status for timely renewal and renewal support.
5.Safeguards the integrity of privileged information and credential files in a professional, sensitive manner
6.Identifies sanctioned providers on state and federal disciplinary reports and initiates the requisite corrective processes to address cited violations
7.Quarries the Nation Practitioner Data Bank as needed, and does so in compliance with the Healthcare Quality Improvement Act (HCQIA)
8.Remains complaint with and knowledgeable of rules and regulations set forth by HIPAA, Joint Commission, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid Services, as well as state regulations and relays this information to the necessary parties to ensure ongoing compliance organization-wide
9.Serves as credentialing contact for employed physicians and advanced practice professionals. Monitors employed physicians and advanced practice professionals' credentials including

Careers

At Scotland Health Care System, we're proud to employ a team of dedicated professionals who embody the Scotland Way.

Founded in 1946, Scotland Health Care System is a community-owned, not-for-profit organization serving Laurinburg, North Carolina. Our mission is simple yet powerful: to deliver safe, high-quality, compassionate, and sustainable health care to everyone in need.

We offer a full spectrum of services-including inpatient, outpatient, and emergency care-along with specialized programs in cancer treatment, cardiac care, surgical services, and women's health.

Our culture is built on caring-for our patients and for our people. We believe that when we take exceptional care of our employees, they can provide exceptional care to our communities. That's why we offer:

• Competitive compensation
  
• Family-friendly benefits including Paid Parental Leave and On-Site Childcare
  
• Flexible scheduling
  
• Exclusive savings programs
  
• Career growth and advancement opportunities
  

If you're looking for more than just a job-if you want a meaningful career where you can make a difference-Scotland Health Care System is the place for you. Join our team today!