Job Information
Denver Health Credentialing Specialist I in Denver, Colorado
We are recruiting for a motivated Credentialing Specialist I to join our team!
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DepartmentMedical Staff Services and Provider Enrollment
Job Summary
Under minimal supervision coordinates, monitors and maintains the credentialing and re-credentialing process for the Medical Staff and Advanced Practice Providers. Ensures compliance with the accrediting and regulatory agencies (i.e., TJC, NCQA, and CMS) in regards to credentialing while developing and maintaining a working knowledge of the statues and laws. Assists in the development, planning, and implementation of the credentialing and privileging process. Responsible for the integrity of the credentialing and privileging database and for ensuring the timeliness of credentialing and re-credentialing verifications.
Essential Functions:
Facilitates all aspects of credentialing and privileging for initial appointments and reappointments. Processes initial appointments and reappointments for assigned Medical Staff and Advanced Practice Providers in a timely manner and tracks the application from time of receipt to Board approval. (65%) Applies working knowledge of the applicable standards, laws, regulations, Medical Staff Bylaws, and Credentialing and Privileging Appointment Policies and Procedures. (10%) Monitors and tracks performance assessments, and competency evaluations for Focused and Ongoing evaluations for the Medical Staff and Advanced Practice Providers. Works closely with the Director's of Service or designee to track and notify when evaluations are due. (10%) Responsible for the accuracy and integrity of the credentialing and privileging database system. Tasks are performed to completion with minimal errors and are accurate, thorough, and timely (10%) Performs complete file reviews for delegated credentialing audits. Validates that all required credentialing elements are complete and accurate. Provides all necessary documentation for all delegated contracts with insurance companies. (5%) Education:
High School Diploma or GED Required Work Experience:
1-3 years Three years' experience in credentialing and privileging in Medical Staff Required CPCS or CPMSM Preferred. If hired without certification, must be able to obtain within 3 years Required Licenses:
Knowledge, Skills and Abilities:
Knowledge of TJC, NCQA and CMS credentialing standards preferred. Ability to interpret and apply policies and procedures. Ability to communicate in a professional and positive manner. Must be able to work independently and meet schedules and deadlines. Computer proficiency in Windows Microsoft Office Suites Internet Browser, i.e., Chrome, Internet Explorer, etc.
ShiftDays (United States of America)
Work TypeRegular
Salary$23.15 - $31.32 / hr
Benefits
Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans
Free RTD EcoPass (public transportation)
On-site employee fitness center and wellness classes
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education & development opportunities including career pathways and coaching
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS)... For full info follow application link.
"Denver Health is committed to provide equal treatment and equal employment opportunities to all applicants and employees. Denver Health is an Equal Opportunity Employer and oes not discriminate against any employee or applicant for employment because of race, color, sex, age, national