AMVETS Jobs

Veterans Preference: To ensure compliance with the Jobs for Veterans Act, this job posting will be available only to veterans for the first 24 hours. After this period, the job will be released to all job seekers.

Job Summary:

As a Credentialing Specialist, you will play a vital role in ensuring that healthcare professionals meet all necessary qualifications and credentials to practice within our organization. Your attention to detail, organizational skills, and knowledge of credentialing processes will be crucial in maintaining compliance with regulatory requirements and ensuring the highest standards of patient care.

Key Responsibilities:

1. Credentialing Process Management:

• Manage the credentialing process for healthcare providers, including physicians, nurses, and allied health professionals.
• Ensure all credentialing applications are completed accurately and in a timely manner.
• Verify credentials, licenses, certifications, and other required documentation.

2. Compliance and Regulation:

• Stay current with regulatory requirements related to credentialing and privileging.
• Ensure adherence to all accreditation standards, such as those from NCQA, CARF, and other relevant bodies.

3. Database Management:

• Maintain accurate and up-to-date provider information in credentialing databases such as Availty, CAQH, Medicare, MedicaidNPI data base, and other relevant data bases.
• Track credentialing expirations and renewals to ensure compliance with organizational policies and external regulations.

4. Communication and Collaboration:

• Communicate effectively with healthcare providers and internal stakeholders regarding credentialing status and requirements.
• Collaborate with various departments, including Human Resources, Legal, and Clinical Operations, to facilitate the credentialing process.

5. Quality Improvement:

• Participate in quality improvement initiatives related to credentialing processes.
• Identify opportunities for process enhancement and efficiency.

Qualifications:

1. Bachelor's degree in Healthcare Administration, Business Administration, or a related field (preferred).

2. Experience in credentialing and privileging within a healthcare setting (required). Employee Must meet the pre-employment requirements set by NM Regulation, MEDICARE, CARF and LifeHouse policy

3. Knowledge of healthcare regulations and accreditation standards.

4. Strong organizational skills and attention to detail.

5. Excellent communication and interpersonal skills.

6. Ability to work independently and as part of a team.

7. Proficiency in using credentialing software and databases.

Summary: Joining our team as a Credentialing Specialist offers you the opportunity to contribute to the delivery of high-quality healthcare services by ensuring that providers are properly credentialed and qualified. Your role is pivotal in maintaining compliance, supporting patient safety, and fostering a collaborative healthcare environment