Credentialing Specialist – Managed Care AdventHealth Corporate
Location Address: 1051 Winderley Place Maitland, FL 32751
Top Reasons To Work At AdventHealth Corporate
Immediate Health Insurance Coverage
Career growth and advancement potential
Full-Time, Monday – Friday
You Will Be Responsible For:
Coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
Conducts thorough background investigation, research and primary source verification of all components of the application file and ensures provider files are current and noted in detail in the system of record.
Achieves productivity standards as determined by management.
Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
Prepares credentials file for completion and presentation to the AH Delegated Credentialing Committee (DCC) or other affiliated credentialing committees within AH, including Clinically Integrated Network (CIN) committees ensuring file completion within time periods specified.
What You Will Need:
High school diploma or GED
Minimum 5 years of healthcare experience with 1 year directly related to hospital medical staff or managed care credentialing and/or provider enrollment.
Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis
NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) or actively pursuing certification and secure within 1 year in the role.
Knowledge of related accreditation and certification requirements.
Knowledge of medical credentialing and privileging procedures and standards.
Database management skills including querying, reporting, and document generation.
Working knowledge of clinical and/or hospital operations and procedures.
Internal Number: 1725
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