Credentialing & Privileging Specialist Job at Superbeo, Rapid City, SD

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  • Superbeo
  • Rapid City, SD

Job Description

NON-CLINICAL POSITION

  • About Facility:
    • Address: 353 Fairmont Blvd., Rapid City, SD 57701
  • General Information:
    • Minimum Experience:
      • Required to have experience as a Medical Services Professional specific to credentialing/privileging; 1+ years in Healthcare; 1+ years Administrative Experience
      • Preferred to have 3+ years in Healthcare; 3+ years Administrative Experience
    • Will you accept a first-time traveler? Yes
  • Skills Required:
    • Review and processing of provider initial and reappointment applications including but not limited to board certifications, all state licenses, databanks, federations, credentials verification, exclusion checks, etc.
    • Prior credentialing experience: background and education verification; certifications and licenses, ensuring all are current and meet regulatory standards
    • High familiarity with hospital privileging processes
    • Meeting preparation and management Credentials Committee, Medical Executive Committee, Bylaws, Medical Staff Department meetings
    • Audit management specific to Joint Commission, National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state regulations compliance.
    • Experience with credentialing software, notably ECHO/HealthStream (others include Cactus, MD-Staff. Modio)
  • Job Description:
    • **This position does not require a skills checklist non-clinical**
    • Completes credentialing, privileging, enrollment, proctorship, and orientation activities for the Medical Staff and other providers. Acts as a recording secretary for the applicable department meetings. Plans, coordinates and provides support to the staff as needed.
    • Essential Functions:
      • Assists in the credentialing and privileging process and provides support to the Medical Staff Coordinator.
      • Communicates necessary information and requests to the VPMA, Medical Staff Coordinator, and other department staff. Composes correspondence, memos, and reports in an accurate and professional manner in response to the Medical Staff and VPMA needs.
      • Coordinates orientation and proctorship for new physicians and other practitioners with privileges. Maintains, monitors, and reports expirations of physician and practitioner licenses, insurance, DEA numbers, TB test results, and other items as required.
      • Prepares agendas and accurately records and transcribes minutes of medical staff department meetings, committee meetings, and other committee meetings of the Medical Staffs' leadership (i.e. Executive Council).
      • Applies for and maintains compliant Federal, State, and other third-party payor professional provider numbers for all providers employed or contracted by Monument Health.
      • Provides oversight for and maintains the provider enrollment database for appropriate task management, provider communication, and repository of applications and files.
      • Completes necessary enrollment, re-enrollment, and change applications in an accurate and timely manner.
      • All other duties as assigned.
  • Required Certifications:
    • None required
  • Required Education:
    • High School Diploma/GED Equivalent in General Studies (Required)
    • Associates degree in Healthcare (Preferred)
  • Orientation Period:
    • 2 weeks minimum
  • Scheduling:
    • Weekend rotation: no weekends
    • Holiday Expectations: no holidays
    • RTO Approval: Manager to approve
    • Shift times: Monday-Friday 8-5
  • Other notes:
    • Business Casual Attire
    • Parking: free parking in designated areas

Job Tags

Holiday work, Casual work, Shift work, Monday to Friday,

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