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Credentialing Specialist

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New York City Health + Hospitals


New
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Published 23 hours ago

March 1, 2021
Salary commensurate with experience

NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.

This temporary position will function as a credentialing specialist for the Division of Medical and Professional Affairs. Under supervision and reporting to the medical staff office, the Credentialing Specialist will assist with performing primary source verifications and related functions.

 Function and Responsibilities include:

Analyzes and evaluates primary source verification data and documents for initial appointments and reappointments to the Medical and Allied Staff according to hospital and outside regulatory standards (Joint Commission, Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), etc), as a function of the hospital’s risk management program for both hospital and delegated credentialing and hospital privileges. 

Manages data quality and integrity for web-based applications based on defined standards through systematic audits.

Functions as an agent of the protected peer review process.

·        Processes applications in a timely fashion, analyzes data, identifies red flags, and items requiring further review/additional information

·        Maintains credentials files in an orderly fashion

·        Maintains accuracy of medical staff database using consistent language for accurate reporting

·        Maintains current status for licensure, DEA registration, certifications, and professional liability insurance

·        Utilizes resources effectively, including the internet, while maintaining costs associated with credentialing

·        Appropriately interprets Joint Commission, NCQA, URAC, CMS, and other regulatory standards and applies this information to the credentialing and privileging process

·        Maintains open communication with applicants and Medical Staff leaders on a weekly basis

·        Maintains mechanism for communicating medical staff demographic and privilege changes within the organization

·        Prepares agendas for, attends, and records minutes for assigned meetings. Follows up as required

Demonstrates knowledge of regulatory standards that pertain to credentialing

Minimum Qualifications

An associate's degree

Preferred Qualifications

Familiarity with MD Staff Credentialing System

Familiarity with TJC, NYS, NCQA, CMS standards/regulations



NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our…

Details at a glance

  • Full Time Schedule
  • Temporary
  • 2-Year Degree Required
  • Entry level

Level of Language Proficiency

Ability to communicate in English with excellent oral and written communication skills are essential

Ability to communicate in English with excellent oral and written communication skills are essential

Location

On-site
125 Worth Street, New York, NY 10013

How to Apply

Please send a word or PDF copy of your resume to the indicated email.

Please send a word or PDF copy of your resume to the indicated email.

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