CREDENTIALING SPECIALIST

Job Description

Job Description

Description:

The health services that became the Anthony L Jordan Health Corporation (Jordan Health) began more than 100 years ago, in 1904. As one of the first 5 Federally Qualified Health Centers (FQHC) established in the nation, its roots are steeped in service to those who face barriers to health and health care, meeting their need for comprehensive medical, dentistry, behavioral health, and community services. Starting in northeast Rochester, NY, Jordan Health has since expanded to become a network of primary care offices and health centers serving residents living in three quadrants of Rochester, NY and in Canandaigua, N.Y.

Jordan Health is now seeking a Credentialing Specialist who, under the guidance of the Chief Compliance & Risk Officer, is primarily responsible for assuring the credentialing, re-credentialing and privileging of healthcare providers, Other Clinical Staff (OCS), Other Licensed or Certified Practitioners (OLCP), and practice sites are conducted in accordance with organizational policies, operational procedures, and applicable governmental and regulatory agency regulations and standards.

If you want to apply your specialized experience and education in an environment where you can make a difference and significantly impact patients’ quality of life, please consider our Credentialing Specialist opportunity.

The Credentialing Specialist will ensure that:

· All aspects of the credentialing, re-credentialing and privileging processes for all medical providers and OLCP who provide patient care and all OCS at Jordan Health are in compliance with state, federal, local and NCQA (National Committee for Quality Assurance) and HRSA standards.

· The renewal of all licenses and certifications is timely.

· Provider files with all essential information required by the government and payer applications are maintained.

· The renewal of all Jordan Health facility payer applications and faculty rosters is timely.

· Credentialing processes in relation to physicians and various other healthcare professionals are created and executed.

· Audited records are 100% in compliance with HRSA, state, federal and NCQA (National Committee for Quality Assurance) standards.

· Organization and department effectiveness and efficiencies are enhanced.

Education and Experience Required:

· Associate’s degree in healthcare administration, Business Administration, Public Health, or a related field required, Bachelor’s degree preferred.

· Minimum of three (3) years of experience in credentialing, provider enrollment, healthcare insurance or related healthcare administrative operations required. Equivalent combination of education and relevant experience may be considered.

· Computer database skills and proficiency with Word, Excel, Access, and Internet resources required.

· Demonstrate ability to establish and maintain effective working relationships with clinicians, management, staff, and contacts/contractors outside the organization.

· Excellent customer service skills and orientation.

· Detailed orientated

· High degree of organizational skills and capabilities.

Licenses and Certifications:

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

· Notary Public certification preferred.

Special Skills, Knowledge Required:

· Excellent written and verbal communication skills.

· Must be self-motivated.

· Able to resolve issues efficiently, effectively.

Benefits: Jordan Health offers a competitive salary and full benefits offering including medical, dental, vision, life insurance, and 403b retirement plan. We offer Professional Development allowance.

Jordan Health offers equal opportunities to all persons without regard to race, color religion, age, sex, disability, national origin, ancestry, citizenship, military or veteran status, marital status, sexual orientation, domestic violence victim status, predisposing genetic characteristics or genetic information, or any other status protected by law.

About Jordan Health:

Jordan Health is an independent FQHC, with Level III Patient-Centered Medical Home (PCMH) designation through the National Committee on Quality Assurance. Jordan Health receives funding from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services. Jordan Health is a network of outpatient primary care offices with providers who follow a panel of patients. While independent, Jordan Health actively collaborates with the major hospital and healthcare systems in our operating area to provide a total safety net of healthcare services.