Credentialing Specialist

Credentialing Specialist

Planned Systems International with ProClivIT is seeking a Credentialing Specialist to provide centralized credentialing and privileging services and support to the United States Army Reserve (USAR) Command with initial entry credentialing, maintenance of credentialing and privileging, and support the Centralized Credentials Privileging Board's review of completed credentials and privileging files.

Essential Functions and Job Responsibilities

Individuals will be responsible for managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health). This includes reviewing applications for completion, verification of state licensure, collecting information contained in the national physician data bank, collecting information from the Health Care Integrity and Protection Databank, collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals. Job duties will specifically also include:

• Implementing USAR policies and standards to ensure that credentialing operations are complying.
• Working with applicants and USAR staff to support and enhance credentialing functions.
• Completing verifications and ensuring that the organization and staff are in accordance with USAR directives and industry trends and standard credentialing procedures.
• Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results.
• Generating and emailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing.
• Data entry into CCQAS as the official system of record.
• Prepare and maintain reports of employees based on accreditation, education, facility privileges, experience, membership and licensure, ensuring all employee information meets federal, state and local guidelines.
• Maintain regular written and verbal correspondence with agencies, hospitals, malpractice carriers and medical review boards.

Minimum Requirements

• Two plus years of credentialing experience with the DoD utilizing CCQAS/ JCCQAS.
• Two years of experience in performing the following functions: conduct administrative and record keeping aspects of the operation of engineering or technical projects / programs; apply knowledge of office management, methods and procedures in producing and maintaining documentation, correspondence, records or directives; work in regard to matters such as project / program progress and status documentation, budget, finance property accounting or personnel.
• Knowledgeable of requirements for verifying doctors' or other types of practitioners' credentials, processing the information and maintaining information data files.
• Have knowledge, and the maintain awareness, of current American Accreditation Healthcare Commission standards.
• Proficient with Microsoft Office software, to include, but not limited to Word, PowerPoint, Excel, Outlook, etc.
• Excellent verbal and written communication skills, including excellent customer relationship skill sets.
• High School Diploma or Equivalent

Desired Qualifications

• Bachelor's Degree in Healthcare, or related field. An equivalent combination of education, certification, and relevant experience may be considered.
• Experience in Quality Assurance preferred.
• Experience in the DOD credentials process preferred

Company Benefits

PSI offers full-time, benefits eligible employees a competitive total compensation package that includes paid leave, and options for employer sponsored group medical, dental, vision, short-term and long-term disability, life insurance, AD&D coverage, legal services, identity theft, and accident insurance. Flexible spending account and health saving account options offer pre-tax savings for qualified medical, dental, and vision expenses. The company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested. We invest in the professional growth of our employees through professional courses, certifications, and tuition reimbursement programs.

EEO Commitment

It is company policy to promote equal employment opportunities. All personnel decisions, including, but not limited to, recruiting, hiring, training, promotion, compensation, benefits, and termination, are made without regard to race, color, religion, age, sex, sexual orientation, pregnancy, gender identity, genetic information, national origin, citizenship status, veteran status, protected veteran status, disability, or any other characteristic protected by applicable federal, state, or local law.

To ensure fair and consistent consideration of all applicants, all candidates must submit a formal application through Planned Systems International's Applicant Tracking System (ATS), iCIMS. Resumes submitted via email, social media, referrals, recruiting events, or other means will not be considered an official application and must be accompanied by a completed online application in the ATS before a candidate can be considered for employment. Reasonable accommodations for applicants and employees with disabilities will be provided. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, or to receive an update regarding the status of your application, please contact Talent Acquisition by emailing View email address on click.appcast.io, or by dialing View phone number on click.appcast.io.