SUMMARY:
Under general supervision, coordinates primary source verification of appointments and reappointments for the credentialing process for Saint Alphonsus.
ENVIRONMENT: Remote with occasional needs to report to the Boise office. Traditional day-time hours. You will work in a close-knit team with knowledgeable colleagues who will support train and mentor you.
REQUIREMENTS:
Certified as a Provider Credentialing Specialist (CPCS) by the National Association Medical Staff Services (NAMSS) preferred.
2 years of medical office experience required.
Payor insurance preferred
Payor enrollment experience prefered
Ability navigate Excel spreadsheets
Comfortable with task-oriented functions
Excellent communication skills required
WHAT YOU WILL DO:
Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions.
Follows all aspects of the initial credentialing and re-credentialing process as outlined in the Medical Staff Bylaws.
Collecting information from practices and providers to elicit information.
Responsible for quality control, completeness and accuracy of practitioner and allied health professionals' credentials files.
Performs source verifications and inputting data accurately into the databases.
Researches credentialing and re-credentialing and assures process is in accordance with the Medical Staff Bylaws, the Joint Commission and NCQA standards. This can be accomplished online or through other study guide materials provided by the department.
Monitors the changes in the Joint Commission and NCQA standards and recommends to the appropriate Committee necessary changes to meet standards.
Knowledge of credentialing, medical terminology, Joint Commission and National Committee for Quality Assurance (NCQA) standards
MSO software program experience preferred
Experience with concepts of continuous quality improvement.
.Maintains a professional and effective working relationship with the practitioners and allied health
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.