Credentialing Specialist – Credentials Verification Organization

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Bon Secours Mercy Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2018

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Bon Secours Mercy Health is a leading health care organization committed to transforming health care delivery and services through strategic innovation and compassionate care. Operating hospitals and clinical sites in the U. S. and Ireland, the organization focuses on extending health care access, improving patient outcomes, and enhancing value through emerging technologies and strategic partnerships. With a commitment to service and stewardship, Bon Secours Mercy Health also prioritizes enhancing the quality of life for underserved communities while advocating for sustainability. The organization’s initiatives include digital innovation, diversified growth through investments and partnerships, and providing high-value care across its core clinical operations.

📋 Description

• Facilitate CVO provider application and data collection, application processing, and Primary Source Verification (PSV) • Support organizational onboarding and offboarding processes • Execute credentialing and re-credentialing applications and verification processes • Ensure applications are correct and complete, resolving discrepancies according to regulatory standards • Prepare files and documents for Medical Director, Credential Committee, and Medical Staff Office review • Work with credentialing auditors to correct deficiencies • Organize and maintain provider data and files • Process applications promptly while meeting turnaround-time, accuracy, CVO, and regulatory benchmarks • Maintain accurate provider database information • Complete credentialing compliance checkpoints • Maintain awareness of TJC, NCQA, CMS, and other regulatory compliance guidelines • Communicate with colleagues, customer relations, MSO representatives, and leadership to collect missing information and resolve issues • Maintain privacy and confidentiality

🎯 Requirements

• High School or GED required • 1 year recent experience in medical staff services or a CVO setting preferred • CPMSM or CPCS certification by NAMSS preferred • Bachelor's or Master's degree in Business, Healthcare, or another related field preferred • CredentialStream credentialing software training strongly preferred • Knowledge of applicable regulatory standards and primary source verification processes • Strong professional communication skills • Ability to protect privacy and confidentiality • Ability to meet turnaround-time, accuracy, CVO, and regulatory benchmarks

🏖️ Benefits

• Competitive pay • Incentives • Referral bonuses • 403(b) with employer contributions (when eligible) • Medical, dental, vision, and prescription coverage • HSA/FSA options • Life insurance • Mental health resources and discounts • Paid time off • Parental and FMLA leave • Short- and long-term disability • Backup care for children and elders • Tuition assistance • Professional development and continuing education support