远程工作雷达

认证专员

Credentialing Specialist

其他限定地区（需当地身份）
公司The Smilist
薪资$65,000 - $75,000/年
工作地点United States
地域资格限定地区（需当地身份）
时区要求日间重叠约 9 小时，基本正常作息
用工类型Full Time
发布时间今天
数据来源Himalayas
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注意地域限制：该职位明确限定在 United States 招聘。如果你是位于中国大陆的求职者，通常需要当地工作身份才能投递，或需与雇主确认是否接受独立合同（Contractor）形式合作。

凭证专员负责管理医疗提供者的凭证和重新凭证流程，以确保符合组织和监管标准。该职位涉及验证提供者的资质、执照和专业资格，并维护准确的记录和数据库。理想的候选人应注重细节、高度有条理，并具备管理文件和截止日期的技能。

职责与工作内容

  • 凭证与重新凭证：
  • 对新旧医疗提供者进行彻底的凭证和重新凭证流程，验证其资质、执照、证书、教育背景、工作经历和其他相关凭证。
  • 确保凭证文件符合监管、认证和内部要求。
  • 跟踪并管理所有凭证的过期和续期，以保持提供者文件的最新状态。
  • 验证与合规：
  • 通过原始来源验证凭证，包括联系教育机构、执照委员会和前雇主。
  • 确保凭证活动符合认证机构（如NCQA、URAC、联合委员会）以及州和联邦法规设定的标准。
  • 在凭证过程中识别并解决任何差异或潜在的合规风险。
  • 数据库与记录维护：
  • 在凭证数据库和系统中维护准确的提供者信息，确保记录及时且有条理。
  • 跟踪凭证状态、执照过期和续期情况，并在数据库中记录更新。
  • 定期审核凭证文件，以确保符合政策并保持记录的高标准准确性。
  • 沟通与协调：
  • 在凭证过程中作为提供者的主要联系人，回答问题、提供指导并提供状态更新。
  • 与内部团队（如招聘、人力资源和医疗人员服务）合作，支持顺利的入职和凭证流程。
  • 与外部组织（包括执照委员会、教育机构和认证机构）有效沟通，以及时完成验证。
  • 报告与文档：
  • 编制并维护关于凭证指标的报告，如申请状态、处理时间及合规率。
  • 按照规定记录所有凭证活动、沟通和决策。
查看英文原文

The Credentialing Specialist is responsible for managing the credentialing and re-credentialing processes for healthcare providers to ensure compliance with organizational and regulatory standards. This role involves the verification of provider credentials, licenses, and professional qualifications, as well as maintaining accurate records and databases. The ideal candidate is detail-oriented, highly organized, and skilled in managing documentation and deadlines.
Duties and Responsibilities

  • Credentialing & Re-credentialing:
  • Conduct thorough credentialing and re-credentialing processes for new and existing providers, verifying qualifications, licenses, certifications, education, work history, and other relevant credentials.
  • Ensure compliance with regulatory, accrediting, and internal requirements for credentialing documentation.
  • Track and manage all credential expirations and renewals to maintain up-to-date provider files.
  • Verification & Compliance:
  • Verify credentials through primary source verification, including contacting educational institutions, licensing boards, and previous employers.
  • Ensure credentialing activities adhere to standards set by accrediting bodies (e.g., NCQA, URAC, Joint Commission) and state/federal regulations.
  • Identify and resolve any discrepancies or potential compliance risks during the credentialing process.
  • Database & Record Maintenance:
  • Maintain accurate provider information in credentialing databases and systems, ensuring records are current and organized.
  • Track credentialing status, license expirations, and renewals, and document updates in the database.
  • Regularly audit credentialing files to ensure compliance with policies and maintain a high standard of record accuracy.
  • Communication & Coordination:
  • Act as the main point of contact for providers during the credentialing process, answering questions, providing guidance, and offering status updates.
  • Collaborate with internal teams, such as recruitment, HR, and medical staff services, to support a smooth onboarding and credentialing process.
  • Communicate effectively with external organizations, including licensing boards, educational institutions, and accreditation agencies, for timely verifications.
  • Reporting & Documentation:
  • Prepare and maintain reports on credentialing metrics, such as application status, processing times, and compliance rates.
  • Document all credentialing activities, communications, and decisions in line with regulatory requirements and company standards.
  • Assist in updating credentialing policies and procedures to improve processes and ensure compliance.

Qualifications:

  • Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field (or equivalent experience).
  • 2+ years of experience in credentialing, medical staff services, or a related role in a healthcare setting.
  • Knowledge of credentialing standards (NCQA, URAC, Joint Commission) and federal and state regulations.
  • Excellent attention to detail, organizational, and time-management skills.
  • Strong communication and interpersonal skills, with the ability to work effectively with internal teams and external contacts.

Preferred Skills:

  • Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) is a plus.
  • Experience in the Dental Industry
  • Familiarity with credentialing software or systems (e.g., CAQH, Echo, Healthstream, or symplr).
  • Background in healthcare administration or medical office experience.

Salary - $65,000-$75,000
This is a remote position.
Originally posted on Himalayas

本页面信息整理自 Himalayas，版权归原发布方所有。职位可能随时关闭，投递请以原始页面为准。 本站只做信息聚合展示，不参与招聘流程，也不向求职者收取任何费用。

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