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Credentialing/Verification Office Specialist

Springfield, IL 62781 | Fully Remote

Posted: 02/01/2024 Job Type: Contract Industry: Other (HR, Admin, Mkt, Sales) Job Number: 24813 Pay Rate: $ 43.00 - $ 45.00

Job Description

Our client, one of the leading healthcare organizations in Illinois, is a community-based, not-for-profit organization that provides a full range of inpatient, outpatient, home health, hospice, behavioral health, and primary care physician services. With eight affiliates they deliver high-quality, patient-centered care in support of our mission to improve lives and build stronger communities through better health.

Our client is looking for a Credentialing Specialist to work with their CVO.

Remote position - May be required to come onsite for training if does not hold  Medical Services Management (CPMSM) and/or Provider Credentialing Specialist (CPCS) certification.
The contract is for 6 months with the possibility of being extended or converted to a Direct Hire.
Equipment will be provided.

Must Have:
  • MD-Staff - Credentialing Software Experience
  • Years of Experience: 3 years min, ideally 5+ years
  • Working knowledge of medical terminology 
  • Excellent verbal and communication skills 
Nice to have:
  • Certification: Medical Services Management (CPMSM) and/or Provider Credentialing Specialist (CPCS) certifications or the equivalent of 3 years of experience 

Position Summary:
  • Assist the System Director, Credentialing, and Medical Staff Services, in the credentialing and verification upon initial application and reapplication to the medical staff.  Works with their leader to improve the credentialing and verification process, streamline hospital privileging and support managed care credentialing. Embodies the System Performance Excellence Standards of Safety, Courtesy, Quality, and efficiency that support our client's mission, vision, and values.

Job Requirements

  • A bachelor's degree in business or health-related field is desirable
  • Successful completion and ongoing maintenance of the Medical Services Management (CPMSM) and/or Provider Credentialing Specialist (CPCS) certifications
  • A minimum of three years experience in medical staff services
  • Proven experience in maintaining collegial working relationships with physicians, allied health professionals, and members of the leadership team.
  • Proven team player.
Duties & Responsibilities:
  • Responsible for credentialing Medical Staff initial applicants and reapplicants to affiliates under the oversight of the System Director, Credentialing and Medical Staff Services
  • Overseas the practitioner credentialing database ensuring accurate and current information is available to all stakeholders.
  • Participates in the development and implementation of credentialing processes and procedures.
  • Audits, assesses, procures, implements, effectively utilizes, and maintains practitioner/provider credentialing processes and information systems (e.g., files, reports, minutes, databases) by analyzing the needs and resources of medical services/credentialing
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