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Credentialing Specialist

Robbinsdale, MN

About North Memorial Health

At North Memorial Health, you're part of an inclusive health family that is rooted in our values of relationships, inventiveness, and accountability. Empathy and care are at the heart of North's culture which is designed to actively support each team member's wellbeing and growth. Our strength lies in our diversity, and we embrace the unique contributions and experiences of each person. Together, we empower customers to achieve their best health.

About this position

Processes medical staff/allied health professional applications, which may involve primary source verification of all elements of the application.

 

What we’ll expect from you

• Maintains compliance with regulatory and accrediting bodies.
• Participates in the development and implementation of credentialing processes and procedures.
• Reviews applications and other data for accuracy and completeness. Contacts clients or applicant, or coordinates with provider relations specialist, to resolve questions and/or to obtain missing information or documentation to fulfill established criteria
• Collects and analyzes verification information.
• Reports on the status of processing information to appropriate persons.
• Initiates processing and follow-up steps to complete credentials verification in a timely manner.
• Coordinates the completion of an application/portfolio, and reviews the application for completeness and accuracy. Contacts appropriate medical staff or allied health leader that applicant information is ready for review/ recommendation.
• Distributes information to hospital departments regarding new applicants.
• Notifies applicants of appointment/reappointment to the medical staff or allied health professional staff as needed
• Inputs/updates data on provider in Cactus database.
• Clinic Services: Specialists in Clinic Services also edit credentialing database for missing elements, create special request reports and/or labels when standard queries and /or reports don't provide adequate data, coordinate changes/additions to credentialing database and edit and manage data related to reference tables.
• Accepts other duties as assigned to promote the accomplishment of organizational goals.
• The team member is accountable to demonstrate proficiency for the skills outlined in the appropriate position skills list.
• The team member is accountable to maintain skill proficiency, including improvement where deemed necessary, and upgrading any additional or new skills on the appropriate position skills list. • Recognizes and complies with legal, regulatory, accrediting and procedural requirements related to area of responsibility.
• Understands and follows principles and standards as outlined in North Memorial's Corporate Code of Conduct.
• Protects customer and team member privacy and only accesses customer and/or team member related information as needed to perform job duties.
• Reports violations or areas of concern to supervisor or Corporate Compliance Officer via established methods of communication.

• Understands and follows principles and standards as outlined in North Memorial's Corporate Code of Conduct.
• Protects customer and team member privacy and only accesses customer and/or team member related information as needed to perform job duties.
• Reports violations or areas of concern to supervisor or Corporate Compliance Officer via established methods of communication.
• Recognizes and complies with legal, regulatory, accrediting and procedural requirements related to area of responsibility.
• Understands and follows principles and standards as outlined in North Memorial's Corporate Code of Conduct.
• Protects customer and team member privacy and only accesses customer and/or team member related information as needed to perform job duties.
• Reports violations or areas of concern to supervisor or Corporate Compliance Officer via established methods of communication.

Interested? Here are our requirements

Education

• High School graduate or equivalent (i.e. GED) required.   

Experience, Knowledge, Skills, Abilities 

• Two years' experience in a medical staff office, managed care credentialing or central verification credentialing organization preferred.
• Clinic Services: Two years' experience in payer credentialing preferred.
• Lead: Three years experience in a medical staff office, managed care credentialing or central verification organization preferred. • Able to maintain confidentiality.
• Possesses good organizational skills; ability to prioritize and manage multiple tasks.
• Strong computer skills required.
• Lead: Credentialing software and report writing skills required.
• Ability to work independently with little or no direct supervision.
• Knowledge of Hospital accrediting regulations and other applicable regulations as they relate to the medical staff.      

Licensure/Certification(s) Mandatory

 

Licensure/Certification(s) Mandatory where Applicable

    

Licensure/Certification(s) Preferred

CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) through the National Association of Medical Staff Services - NMHC Preferred     

Posting Date:


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EEO/AA STATEMENT

North Memorial Health is an equal employment and affirmative action employer. North Memorial Health does not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability, genetic information, marital status, veteran status, sexual orientation, gender identity, creed, status with respect to public assistance, or other protected class status. North Memorial Health provides reasonable accommodation to disabled applicants and employees and takes affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to protected class status. If you believe that you have been treated in a way that does not conform to these statements, please contact our HR Service Center: 763-581-6947. If you need a reasonable accommodation, due to a disability, or to assist with the application process, please contact our HR Service Center: 763-581-6947.


INSPECTION OF AAP
North Memorial Health is a Federal government contractor or subcontractor.
As a part of our obligations under law, we must develop a written Affirmative Action Program for Individuals with Disabilities and Protected Veterans, as specified by law (AAP).
This AAP is available for inspection by applicants and employees in the Human Resources Office during normal business hours.
Link to Policy



North Memorial Health

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A culture of unmatched customer service

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A culture of unmatched customer service

Ready to be inspired? Join an empowering, supportive, and responsive environment that delivers unmatched experience to customers across the Twin Cities. Join our health family at North Memorial Health.

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North Memorial Health has always provided an equal opportunity for me to excel within this organization while pursuing a passion to help others with the support of a true team!Robert, North Memorial Health Pharmacy Technician

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