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Credentialing Specialist I

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Boston Children's Hospital

Sep 20

  • Job
    Full-time
    Junior Level
  • People, HR & Administration
    Healthcare
  • Germany, +11
    Remote

AI generated summary

  • You need an Associate's Degree or one year of technical training, plus one year of experience in healthcare and credentialing. Attention to detail and strong organizational skills are essential. New England candidates preferred.
  • You will process and review credentialing applications, verify applicant information, liaise with departments, escalate issues, maintain confidential files, and ensure compliance with standards.

Requirements

  • To qualify you must have:
  • Associate's Degree in the field of Medical Staff Services Science, Health Care Administration or a closely related field, or one year of basic technical training
  • One year of related experience in a hospital or healthcare environment
  • One year of experience in credentialing, provider enrollment or closely related field.
  • Attention to detail, managing multiple tasks simultaneously, identifying and escalating concerns, and meticulous organization
  • Candidates from New England region preferred.

Responsibilities

  • Processing applications for appointment, re-appointment, and mid-cycle change to the Medical Staff, House Staff, and Associate Clinical Staff, and requesting clinical privileges, as applicable, in a customer-focused, efficient, comprehensive, timely, and accurate manner.
  • Reviewing and evaluating applications, including evidence of education, training, experience, and competency, to determine eligibility for membership and clinical privileges.
  • Obtaining primary source verifications for all information submitted by the applicant or re-applicant.
  • Recognizing, investigating, and validating discrepancies and adverse information obtained from the application, primary source verifications, or other sources; obtaining clarification and escalating concerns.
  • Notifying applicants and re-applicants, and their coordinators, of any issues and maintaining contact with them throughout the process.
  • Compiling, evaluating, and presenting practitioner-specific data collected for review by one or more decision-making bodies in a comprehensive and timely manner.
  • Documenting, according to policy and procedure, applicants and re-applicants with potential issues in a holistic and comprehensive manner.
  • Soliciting and obtaining information from the Department or Division Chief regarding applicants and re-applicants.
  • Escalating concerns, according to policy and procedure, to the chain of command.
  • Performing related credentialing functions, including ensuring all documents are maintained according to policy and procedure.
  • Maintaining confidential credentialing files for all applicants and members of the Medical Staff, House Staff, and Associate Clinical Staff.
  • Enrolling, maintaining enrollment, and terminating members of the Medical Staff, House Staff, and Associate Clinical Staff with the appropriate institutional malpractice carrier.
  • Providing the highest level of service to all customers (internal and external) as demonstrated through the core values of the enterprise.
  • Implementing office goals and objectives using continuous process improvement methods.
  • Maintaining relationships and serving as a liaison between Medical Staff Services and clinical departments and divisions, and their Chief(s), enterprise-wide, to address questions and concerns.
  • Teaching and providing expertise to managers, medical staff, and staff on credentialing processes, requirements, and regulations.
  • Applying relevant Medical Staff Bylaws, Rules and Regulations, and any other relevant regulatory standards to the day-to-day functioning.
  • Creating a customer-friendly and healthy work environment in support of employee engagement and well-being.
  • Assisting in facilitating an efficient, productive, accountable, and customer and quality-oriented work environment using high-reliability principles.
  • Providing and ensuring the highest level of service to all customers (internal and external) as demonstrated through the core values of the enterprise.

FAQs

What are the primary responsibilities of a Credentialing Specialist I?

The primary responsibilities include processing applications for appointment and re-appointment, reviewing and evaluating applications for eligibility, obtaining primary source verifications, investigating discrepancies, notifying applicants of issues, documenting potential issues comprehensively, maintaining confidential credentialing files, and providing expertise on credentialing processes.

What qualifications are required for the Credentialing Specialist I position?

Candidates must have an Associate's Degree in Medical Staff Services Science, Health Care Administration, or a closely related field, or one year of basic technical training, along with one year of related experience in a hospital or healthcare environment and one year of experience in credentialing or provider enrollment.

Is experience in the New England region preferred for this position?

Yes, candidates from the New England region are preferred.

What skills are important for a Credentialing Specialist I?

Key skills include attention to detail, the ability to manage multiple tasks simultaneously, identifying and escalating concerns, and maintaining meticulous organization.

What type of work environment does Boston Children’s Hospital promote for this role?

The hospital promotes a customer-friendly and healthy work environment that supports employee engagement and well-being.

What benefits do employees receive at Boston Children’s Hospital?

Employees receive competitive compensation, flexible schedules, health, vision and dental insurance, child care and student loan subsidies, generous time off, a 403(b) Retirement Savings plan, pension, tuition reimbursement, and discounts on cell phone plans and T-passes.

Will I be working independently or will there be collaboration involved?

This role involves maintaining relationships and serving as a liaison between Medical Staff Services and clinical departments, so collaboration will be an important aspect of the job.

Are there opportunities for professional development in this position?

Yes, the position includes responsibilities like teaching and providing expertise to staff on credentialing processes, which can facilitate professional development.

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Boston Children's Hospital

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Science & Healthcare
Industry
10,001+
Employees
1896
Founded Year

Mission & Purpose

Boston Children's Hospital is a 404-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Boston Children's offers a complete range of health care services for children from birth through 21 years of age. (Our services can begin interventions at 15 weeks gestation and in some situations we also treat adults.) We have approximately 25,000 inpatient admissions each year and our 200+ specialized clinical programs schedule 557,000 visits annually. Last year, the hospital performed more than 26,500 surgical procedures and 214,000 radiological examinations. Our team of physicians and nurses has been recognized by a number of independent organizations for overall excellence, and we're proud to share some notable examples with you here.