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Credentialing Specialist

Company: Good Shepherd Hospice
Location: Melville
Posted on: June 9, 2021

Job Description:

Credentialing Specialist

Facility: CHS Services Inc Location: Melville, NY Department: CHS MedStaff Cred App Proc Ctr Category: Administrative / Business Support Schedule: Full Time Shift: Day shift Hours: 7AM - 3PM ReqNum: 6034573

Catholic Health Services of Long Island (CHS) is an integrated health care delivery system with some of the region's finest health and human services agencies. CHS includes six hospitals, three skilled nursing facilities, a regional home nursing service, hospice and a multiservice, community-based agency for persons with special needs. Under the sponsorship of the Diocese of Rockville Centre, CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping people live their final years in comfort, grace and dignity.

The Credentialing Specialist will be responsible for auditing, data entry performed by clerical staff in Cactus Database, processing the initial and / or reappointment application in a timely manner, communicating with the applicant or re-applicant to keep them abreast on the status of their application and ensure processing is moving smoothly, following up with practitioner on missing items for packet, run all appropriate verifications related to the initial appointment / reappointment process, accurate and timely follow up with verifications i.e. peer references, hospital affiliations, education, training, and work experience, accurate management of Cactus database for updating physician profiles and privileges at initial appointment and reappointment, prepare completed packets for Chief & Chairman / Director Review, post Credentials Committee / Board of Trustees follow up i.e. updating privileges, status of applicant, generating appointment / reappointment letters, etc. and assist practitioners with questions when they call or come to our office.

Additional Responsibilities:

  • Utilizes all available resources to reach sound decisions.

  • Assumes responsibility for problems and initiates actions to solve them.

  • Work with others toward shared goals including participation in department problem-solving and improvement activities.

  • Bring issues related to the credentialing and/or recredentialing process to the attention of management in a timely fashion.

  • Foster change initiatives to ensure continuous performance improvement and service excellence.

  • Participate in Joint Commission preparation and NY State DOH Survey

  • Participate in Managed Care Audits Assist in preparation and mailing of correspondence required for Credentialing, when necessary

  • Provide support services and act as back up to clerical staff when necessary

  • With appropriate training, accept additional related duties, as needed.

  • Participate in education programs, in-service meetings, workshops, conferences, and committees.

  • Keep abreast of current literature and professional trends

  • Review and understand the Medical Staff Bylaws of each CHS Facility Review and understand the Joint Commission Standards Review and understand the NCQA Standards

Requirements:

  • 5 years of Credentialing experience in a hospital setting

  • Proficient in Microsoft Office, including Word and Excel

  • Must have the ability to prioritize and have good listening, written and oral skills

  • Excellent customer service, oral/written communication, interpersonal, and organizational skills

  • Well versed in the use of the Cactus Database CPCS (Certified Provider Credentialing Specialist)

  • Knowledge of Cactus a plus Knowledge or experience with credentialing processes desirable

At Catholic Health Services of Long Island your well-being comes first, with comprehensive compensation and benefits; our offerings go beyond the basics. In addition to multiple medical plans, life insurance, generous paid time off and flexible spending accounts, we also offer substantial tuition reimbursement, an employer funded pension plan and several savings plan options for your future.

Keywords: Good Shepherd Hospice, New Haven , Credentialing Specialist, Other , Melville, Connecticut

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