Credentialing Specialist

Are you a detail-oriented and organized individual with a passion for healthcare? Do you have experience in credentialing and a strong understanding of healthcare regulations and policies? If so, we have an exciting opportunity for you to join our team as a Credentialing Specialist at Presbyterian Healthcare Services.As a Credentialing Specialist, you will play a critical role in ensuring that our healthcare providers are properly credentialed and compliant with all regulatory standards. Your attention to detail and expertise in credentialing will contribute to the success of our organization and the delivery of high-quality patient care.To be successful in this role, you must have a minimum of [X years] of experience in healthcare credentialing and a thorough understanding of industry regulations. You should also possess excellent communication skills, strong organizational abilities, and the ability to work independently and as part of a team.If you are looking for a challenging and rewarding career in the healthcare industry, we encourage you to apply for this position and become a part of our dedicated team at Presbyterian Healthcare Services.

1. Oversee the credentialing process for all healthcare providers, including initial and ongoing credentialing, re-credentialing, and privileging.
2. Ensure that all credentialing activities are in compliance with industry regulations and policies, as well as organizational standards and procedures.
3. Conduct thorough and accurate verification of provider credentials, including education, training, licensure, certifications, and work history.
4. Maintain detailed and organized records of all credentialing activities, including provider information and documentation.
5. Communicate with providers and relevant stakeholders to collect and verify necessary information for credentialing.
6. Collaborate with other departments and teams to ensure timely completion of the credentialing process.
7. Stay up-to-date on changes and updates to credentialing regulations, policies, and procedures.
8. Identify and resolve any issues or discrepancies in provider credentials.
9. Facilitate the resolution of any credentialing-related concerns or disputes.
10. Serve as a resource for providers and staff regarding credentialing requirements and processes.
11. Ensure that all credentialing activities are completed accurately and in a timely manner.
12. Work closely with the compliance team to ensure that all credentialing activities are in compliance with regulatory standards.
13. Participate in audits and reviews of the credentialing process to identify areas for improvement and implement changes as needed.
14. Provide training and support to other team members involved in the credentialing process.
15. Maintain confidentiality and adhere to ethical standards in all credentialing activities.

According to JobzMall, the average salary range for a Credentialing Specialist in Albuquerque, NM, USA is $50,000 to $70,000 per year. However, this can vary depending on factors such as education, experience, and the specific company or organization the specialist works for. Some specialists may earn more or less than this range.

Presbyterian Healthcare Services is a private not-for-profit health care system and health care provider in the State of New Mexico. It owns and operates 8 hospitals in 7 New Mexico communities. It also operates Presbyterian Health Plan.