Credentialing Specialist

This is a fully remote position, open to applicants in Utah.

📋 Description

• Oversee Intermountain Health’s centralized verification office (CVO) program.

• Act as the main credentialing contact for hospitals, providers, and network-participating providers.

• Manage all facets of the Primary Source Verification program.

• Confirm applicants’ education, training, and experience directly with primary sources.

• Review and verify the accuracy of provider information in credentialing software.

• Handle initial credentialing and re-credentialing applications.

• Document primary-source information in computer databases.

• Create and maintain reports on credentialing activities, including accreditation, membership, and facility privileges.

• Ensure that applications adhere to relevant laws, regulations, procedures, and policies.

• Keep updated credentialing guidelines and prepare records and applications for Hospital Medical Staff Office and Medical Staff Committee review.

• Maintain regular communication with medical staff services professionals, administrators, and practitioners.

• Keep CVO leaders apprised of any issues or concerns.

• Integrate accreditation and regulatory standards into medical staff operations.

• Manage provider records, including expiring items and other necessary documents.

• Work Monday to Friday during business hours, with no obligations on holidays, weekends, or nights.

⛳️ Requirements

• Excellent verbal and written communication skills, with the ability to collaborate effectively within a team.

• Intermediate proficiency in Word, Excel, Adobe, and OneNote.

• Willingness to learn a complex database program.

• Capability to work alongside various healthcare professionals.

• Ability to operate with minimal supervision and stay self-motivated.

• Capacity to maintain confidentiality and adapt to frequent interruptions.

• Strong problem-solving and decision-making skills.

• Organizational abilities and effective communication skills.

• Familiarity with TJC and NCQA standards, along with state and federal guidelines and requirements.

• High school diploma or equivalent is required.

• Knowledge of medical terminology is essential.

• A Bachelor's Degree from an accredited institution is preferred.

• CPCS or CPMSM certification is preferred; certification required within five years of employment.

• Minimum of one year of administrative work experience is necessary.

• Previous experience as a medical staff coordinator, medical staff credentials specialist, or privileging coordinator is required.

• At least one year of experience in a healthcare, legal, or insurance environment.

• Ability to read and communicate information effectively with providers, colleagues, customers, patients/clients, and visitors.

• Manual dexterity for computer use and managing supplies/equipment.

🏝️ Benefits

• Comprehensive benefits package that supports wellness, health, security, connection, and engagement.

• Remote work expectations involve the use of company equipment.