企业认证专员
Corporate Credentialing Specialist
公司简介
Shriners Children’s 是一个尊重、支持并重视每个人的组织。被《福布斯》评为 2025 年最佳中型企业之一,我们致力于提供卓越的患者护理,拥抱具有全球影响力的多学科教育和研究。我们营造一个重视循证实践、经验、创新和批判性思维的学习环境。我们的同理心、诚信、责任感和韧性定义了我们在儿童专科护理领域的领导地位,为孩子们及其家庭服务。
我们在全球拥有 20 多家医院、门诊诊所、日间护理中心和外展地点,无论家庭是否具备支付能力或是否有保险,我们都为 18 岁以下的儿童提供优质的护理。请点击此处了解我们的更多地点信息。
现任员工:请登录 Workday 点击此处通过“职位中心”内部申请
职位描述
认证专员负责协调和组织医生及高级执业专业人员的持续认证和特权授予。负责审查、分析和跟进认证和特权申请,保持严格的保密性。确保符合联邦和州机构、组织政策以及认证和监管机构的要求。
主要职责:
- 协调和组织 SHC 设施的认证/特权请求/修改,并支持在附属机构请求特权的医务人员。确保提供教育、培训和经验的证明,以确定所请求特权和会员资格的资格。
- 使用可接受的验证来源验证和记录认证信息和过期信息,以确保符合认证和监管标准,并管理并记录与医务人员和主要设施的所有沟通,以确保通知即将过期的信息。在认证数据库中记录所有认证活动,以确保文件反映当前状态。
- 识别、调查和验证获得的差异和不利信息;获取并评估执业者的处罚、投诉和不利数据,以确保合规。
- 负责保密性和数据录入、维护和分析临床医务人员信息,按照既定指南在数据库中进行,以确保完整的电子认证文件,以支持医务人员注册和授权要求
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Company Overview
Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.
With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe, we provide excellent care to children up to age 18 regardless of their family’s ability to pay or insurance status. Please click here to learn more about our locations.
CURRENT EMPLOYEES: Please log into Workday Click Here to apply internally through the "Jobs Hub"
Job Description
The Credentialing Specialist coordinates and organizes ongoing credentialing and privileging of physicians and advanced practice professionals. Responsible for reviewing, analyzing, and follow-up of credentialing and privileging applications, maintaining strict confidentiality. Ensures compliance with federal and state agencies, organizational policies, and accrediting and regulatory agencies.
Key Responsibilities:
- Coordinates and organizes credentialing/privileging requests/modifications for an SHC facility and supports providers requesting privileges at affiliate locations. Ensures evidence of education, training, and experience to determine eligibility for requested privileges and membership.
- Verifies and documents credentials and expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards, as well as manages and documents all communication with providers and primary facilities to ensure notification of upcoming expirables. Keeps a record of all credentialing activities in the credentialing database to ensure files reflect current status.
- Recognizes, investigates, and validates discrepancies and adverse information obtained; obtains and evaluates practitioner sanctions, complaints, and adverse data to ensure compliance.
- Responsible for confidentiality and data entry, maintenance, and analysis of clinical provider information within database per established guidelines to ensure complete electronic credential file to support provider enrollment and delegation requirements.
- Collaborates credentialing, OPPE, FPPE, and privileging activities with SHC Medical Staff Offices to ensure timely approval process of governing bodies, participation in accreditation surveys and audits, to include verification of appropriate drug and criminal background screenings. Prioritizes workload to meet deadlines.
- Maintains current knowledge of accreditation standards (TJC, NCQA), state and federal regulations, as well as SHC medical staff bylaws, regulations, and procedural rules.
Required Qualifications:
- Experience in a healthcare setting performing regulatory credentialing
- Experience with MD Staff or relevant credentialing database
- Data entry skills. Including the ability to navigate a translational database to enter and retrieve information.
- Competency in Microsoft Office applications
- Certified Provider Credentialing Specialist (CPCS), Certified Professional in Medical Services Management (CPMSM) or equivalent certification. If candidate is not currently certified, CPCS will be required within 24 months of hire, or upon eligibility
- High School Diploma/GED
Preferred Qualifications:
- Associates Degree (A.A.) in relevant healthcare field
- Bachelor’s Degree (B.S., B.A., etc.) in relevant healthcare field
Compensation is determined based on years of relevant experience and departmental equity.Originally posted on Himalayas