Credentialing Specialist

Must Have Experience:

• Three (3) years of experience in medical credentialing to include knowledge of the credentialing and privileging process, the required credentials for healthcare professionals, knowledge of appropriate sources used to complete PSV, work history verifications, and databank queries.
• One (1) year of credentialing experience with the DoD utilizing JCCQAS.

Responsibilities to include but not limited to:

• Completes written PSV documentation capturing the required components to document the PSV IAW DHA PM 6025.13, vol 4 and DAFI 44-119.
• Reviews credentialing applications, conduct follow-up to obtain missing credentials/information, conduct verifications, create provider credentialing records within JCCQAS and maintain the JCCQAS record.
• Contacts medical office staff, educational institutions, employers, licensing and certifying agencies, to obtain and complete the verification of credentials.
• Obtains required credentials and complete PSV of the credentials from the originating source or designated agent, date stamps the documentation upon receipt.
• Updates the appropriate screens within JCCQAS to capture the credential and PSV of the credential. Converts documentation to a PDF format, scans, appropriately names and uploads the documentation to the provider’s electronic credentials file.