Credentialing Specialist (Hybrid)

Position #: 24000CP6
Position: Credentialing Specialist (Hybrid)
UH Facility: University Hospitals
Shift: Days
Status: Full-time
Work Days of Week: M-F

City: Cleveland

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ABOUT US

To Heal. To Teach. To Discover.

These words are more than just our mission, they embody the opportunities available to the world-class doctors, nurses, health care professionals and support staff who choose to join University Hospitals and Be the Difference.

From entry to executive level, every position and every professional at University Hospitals has a direct impact on our ability to offer excellent care to our patients, their families and our community.

Join Us and Be the difference in Advancing the Science of Health and the Art of Compassion.

Equal Opportunity Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.

JOB DESCRIPTION & QUALIFICATIONS

Description

A Brief Overview

Manage all aspects of UH Provider and Central Verification Organization (UH PCVO) credentialing and recredentialing verification process for assigned clients to meet standards and requirements of client, UH PCVO, National Committee for Quality Assurance (NCQA), Joint Commission (JC), Utilization Review Accreditation Commission (URAC), Centers for Medicare and Medicaid Services (CMS), federal and state, and other regulatory or accreditation bodies.

What You Will Do

Collects and analyzes verification information and documents in accordance with accreditation standards noted above for the system-wide initial and reappointment programs.
Records data into the enterprise credentialing software in a timely and accurate manner so that provider information is available to all downstream system feeds including the provider lookups on the internet, intranet, and Soarian etc.
Performs ongoing monitoring and auditing of required credentials including Ohio license, DEA registration(s), malpractice insurance, board certification (s), CPR certification(s), and Visa/Permanent Resident status in accordance with all applicable regulatory standards.
Researches high volume of referring providers to establish identity so that all downstream systems have the same data.
Independently prioritizes assignments including continual special projects to ensure timely completion of work that meets strict accrediting body timelines.
Performs an integral role in system-wide reappointment process.
Collaborates with Medical Staff Coordinators to complete credentials file.
Serves as content expert and participates in onboarding and training of new team members
Supports the medical staff with credentialing related projects as assigned
Collecting practitioner dues, maintaining on-call schedules and meeting management.

Additional Responsibilities

Performs other duties as assigned.
Complies with all policies and standards.
For specific duties and responsibilities, refer to documentation provided by the department during orientation.
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Qualifications

Education

Associate’s Degree (Required) and
Bachelor’s Degree (Preferred)

Work Experience

3+ years experience in an administrative or healthcare field (Required) and
Medical staff or managed care credentialing experience (Required) and
experience with functions performed in a Centralized Verification Organization strongly (Preferred) and
Experience with regulatory standards (e.g., NCQA), and records management (Preferred) and
Excellent computer skills, including Microsoft Word, Access, and Excel Experience with Adobe Acrobat Professional and credentialing software (Preferred)

Knowledge, Skills, & Abilities

Strong analytical skills and excellent written and oral communication skills, including editing and proofreading, to ensure high quality of communication, documentation, and published information. (Required proficiency)
The qualified applicant must possess strong interpersonal skills, teamwork, and ability to communicate effectively with all levels of staff, physicians, leadership, and internal/external customers. (Required proficiency)
Maintenance of confidentiality essential. (Required proficiency)
Demonstrated superior organization skills, priority setting, accomplish work independently and reliably, and multi-task management. (Required proficiency)

Licenses and Certifications

Current NAMSS CPCS certification (Preferred)

Physical Demands

Standing Occasionally
Walking Occasionally
Sitting Constantly
Lifting Rarely 20 lbs
Carrying Rarely 20 lbs
Pushing Rarely 20 lbs
Pulling Rarely 20 lbs
Climbing Rarely 20 lbs
Balancing Rarely
Stooping Rarely
Kneeling Rarely
Crouching Rarely
Crawling Rarely
Reaching Rarely
Handling Occasionally
Grasping Occasionally
Feeling Rarely
Talking Constantly
Hearing Constantly
Repetitive Motions Frequently
Eye/Hand/Foot Coordination Frequently

Travel Requirements

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LOCATION

Working at University Hospitals

Careers at University Hospitals offers opportunities to provide care locally in the Cleveland area with the power to impact healthcare nationwide. As a leader in our industry, our staff share a commitment to Be the Difference in the lives of our patients and our communities, from Northeast Ohio and beyond. Take a look at this video to discover how we’re building an organization for the future, today. Note: video content was obtained prior to the COVID-19 pandemic.

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Contact Us

To contact University Hospitals Human Resources department, or to request a reasonable accommodation, please call 216-767-8900 or send us an email at employment@uhhospitals.org

Equal Employment Opportunity Statement

It is the policy of University Hospitals to provide equal opportunity to all of our employees and applicants for employment. Decisions concerning employment, transfers and promotions or other conditions of employment are all made upon the basis of the best qualified candidate without regard to race, color, national origin, age, religion, veteran status, disability, gender, sexual orientation, gender identity, or marital status in accordance with Federal and Ohio law. A qualified individual with a disability will be considered for employment on the same basis as non- disabled applicants if he/she can perform the essential functions of the job sought, with or without a reasonable accommodation, and without imposing a direct threat to the health or safety of others or him/herself. EEO is the Law

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