The Credentialing Specialist performs the credentialing duties for CentraCare Health. Responsibility may include the application and reapplication process for providers requesting Hospital Medical Staff Membership and clinical privileges, or the application and reapplication process for health plans and outreach hospitals. The Credentialing Specialist ensures compliance with the Joint Commission, NCQA, Centers for Medicare/Medicaid Services, and other laws or Hospital policies.
Provides support to the Director, Credentialing, CentraCare Health Administrators, Clinic Coordinators/managers, St Cloud Hospital Vice President, Medical Affairs, Credentials Committee members, Chief of Staff, Chief of Staff Elect, members of the Medical Staff, physician groups, Advance Practice Providers, the medical staff office and support staff from other health care facilities, health plans, and vendors.
Two years Business College or three years equivalent experience required in lieu of education
Two years hospital and/or health plan credentialing or related experience required. (Related experience would be considered business office, administrative or any other customer service/detailed orientated position)
CPCS or CPMSM certification through NAMSS preferred
National Association Medical Staff Services (NAMSS) membership preferred
Minnesota Association Medical Staff Services (MAMSS) membership preferred
Internal Number: 201807948
About CentraCare Health
CentraCare Health is a not-for-profit health care system that provides comprehensive, high-quality care to people throughout Central Minnesota. Our collaborative network includes hospitals in St. Cloud, Long Prairie, Melrose, Monticello, Paynesville and Sauk Centre, six nursing homes, senior housing in six communities and 17 clinics.
CentraCare also operates numerous specialty services, including the CentraCare Heart & Vascular Center, Coborn Cancer Center and the CentraCare Kidney Program. CentraCare serves all who seek care with compassion, dignity and respect, while seeking to enhance individual and community health.
CentraCare Health works to improve the health of every patient, every day.
CentraCare Health will be the leader in Minnesota for quality, safety, service and value.
•Patient Centered: Serving patients above all.
•Integrity: Adhering to honest and ethical practices.
•Collaboration: Working jointly with others to improve health and health care.
•Compassion: Serving all who seek our care with kindness, dignity, and respect.
•Stewardship: Ensuring responsible use of all resources to best serve our communities.