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Credentialing Specialist - Intermediate

ATR International
Redwood City, California, 94063, United States
July 18, 2018

Job Title: Credentialing Specialist - Intermediate

Job Location: Redwood City, CA

Job Duration: 2 Months

Job Description:

We are seeking a Credentialing Specialist - Intermediate for a very important client

Under supervision, initiates the credentialing process, compiles, and processes data in compliance with Federal, State, Program, and Regional requirements. Ensures thorough and timely verification of physicians credentials according to regional Credentialing Policies and Procedures. Acts as liaison between medical centers and medical offices credentials and privileges coordinators and the regional office.

Major Responsibilities/Essential Functions

-Ensures consistent documentation and complete verification of physicians’ credentials. Provides required

documentation to appropriate physician’s managers and committees in the practice sites.

-Processes all credentials applications and/or applications for employment with TPMG.

-Initiates extensive investigation into the applicants background, education and experience through the use

of on-line systems, written correspondence, telephone inquiries and printed reference guides and reports.

-Partners with the practice site Credentials & Privileges Coordinators to ensure an integrated, timely,

consistent product.

-Collaborates with professional physician recruiters to monitor recruitment status of candidates to ensure

timely credentialing prior to employment.

-Develops and maintains a computerized data base of physician data for use in the credentialing and

appointment process. Prepares reports as requested.

-Maintains files of current Scopes of Practice for all specialties, Professional Staff by-laws for all medical

center and current Federal, State, Program and Regional requirements.

-Implements efficient and effective combinations systems for transmission of credentials information to

practice sites to facilitate timely approval to participate and professional staff appointment.

-Keeps abreast of changes in laws and regulatory requirements. Writes and implements new procedures as

necessary to remain in compliance.

-Works with practice site Credentials and Privileges Coordinators to share and implement best practices

whenever feasible.


The ideal candidate will possess the following skills:

Minimum Education

-Associate's degree required

Preferred Education

-Bachelor's degree preferred.

Minimum Work Experience and Qualifications

-Minimum three (3) years of experience with credentialing in a hospital or medical setting.

Additional Proffered Requirements:

-Proficient with IBM PC, dBase, WordPerfect, and Lotus 1-2-3.

-Proficient with Medical Terminology.

-Significant knowledge of Federal and State regulatory requirements and accreditation standards e.g., The Joint Commission, TITLE 22, NCQA, NPDB, and certifying agencies.

-Strong organization and communication skills and attention to details required.

-Proven ability to function independently with minimal direct supervision.

Preferred Work Experience and Qualifications

-Experience with Med Staff or Medical Information Data Analysis System preferred.

-Certification as Certified Provider Credentialing Specialist (CPCS) preferred.