Facilitate the credentialing and re-credentialing of eligible population across all D-H H system members.
Responsibilities
Process the credentialing and re-credentialing, including the validation of identity, training, experience, reputation and competence of applicants applying or re-applying for membership.
Provides communication regarding the credentialing and re-credentialing process and requirements.
Obtains missing information and clarifies any inconsistencies identified between submitted documentation and verifications.
Ensures timely completion of credentialing and re-credentialing applications.
Ensures that the credentialing/re-credentialing programs maintain compliance with regulatory standards (e.g. TJC, NCQA and CMS, etc.), internal policies and D-H Professional Staff Bylaws, Rules and Regulations.
Conducts quality assurance reviews on credentialing and re-credentialing files.
Enters new data, maintain existing records, and assists in the continued development of the comprehensive credentialing database.
Provides support to system members regarding education and training around the Credentialing process.
Performs other duties as required or assigned.
Qualifications
High school diploma or equivalent with 3 years of experience in healthcare or Human Resources.
Associates degree in business or healthcare related field preferred.
Strong written and verbal interpersonal skills required.
Must be detail oriented.
Demonstrated proficiency in word processing, spreadsheet software, database management and data entry preferred.