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Demonstrate a solid understanding of credentialing and NCQA guidelines around Credentialing and Provider Network. Verifying the accuracy of all submitted credentialing information, and for creating, or auditing accurate Primary Source Verification (PSV) files for delegated credentialing and maintain NCQA Credentialing/Recredentialing Accreditation.
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The Senior Director will provide\ strategic leadership to the HHC System Credentialing Verification Organization (CVO), Medical Staff Office (MSO) and Provider Enrollment teams (PE.
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Successful completion (or on track to sit for the exam within 3 years of assuming this position) and ongoing maintenance of the Medical Services Management (CPMSM) and/or Provider Credentialing Specialist (CPCS) certifications.
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Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred. Reporting to the Chief of Staff, the successful candidate will act as a liaison between the SHC Credentialing Verification Office (CVO) and the SHCNC Medical Staff Office, supporting the credentialing and privileging application process.
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Produces management reports regarding operations performance and/or provider credentialing status for internal management and external providers using the health system's verification services.
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Access to a robust in-house administrative team that supports all clinical programming including intake, verification of benefits, billing, coding, collections, and credentialing. About LifeStance Health LifeStance is a national provider of mental healthcare services focused on evidenced-based, medically driven treatment services for children, adolescents and adults suffering from a variety of mental health issues in an outpatient care setting, both in-person at its clinics nationwide and through its digital health telemedicine offering.
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Help manage all Credentialing Files: Manage internal and external provider credentials, maintain records of expired verification, and ensure the completeness of a file to perform verification of credentials.
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Works with their leader to improve the credentialing and verification process, streamline hospital privileging and support managed care credentialing. Supports Memorial Health Managed Care with their provider credentialing for internal and external managed care credentialing needs under the oversight of the Manager, Credentialing and Medical Staff Services.
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Keywords: Provider Credentialing Specialist, healthcare provider credentialing specialist, health care, credentialing, provider credentials, compliance, credentialing reports, accreditation, membership, facility privileges, legal, federal, state guidelines, application processing, credentialing process, physicians, allied health practitioners, information verification, analyze data.
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Furthermore, the Provider Relations Manager oversees the coordination, compilation, and preparation of reports pertaining to existing practitioners as requested; prepares all correspondence associated with the credentialing and reappointment process; provides verification of employment and malpractice coverage for all medical and dental providers.
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Certified Provider Credentialing Specialist (CPCS) Coordinate the verification process with all aspects related to the credentialing of physicians and allied health professionals.
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Assist Human Resources in provider onboarding as it relates to primary source verification, initial credentialing, the Licensing Specialist is the final reviewer of the provider/applicant's licensing and medical credentialing.
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The Credentialing Specialist is responsible for facilitating all aspects of provider credentialing, including initial appointment, reappointment, credential audits, as well as clinical privileging for Medical Staff, Health Professionals, and all other providers as outlined in the corporate policy and procedures, or hospital bylaws.
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Certified Provider Credentialing Specialist (CPCS) preferred. 5 year's experience in Medical Staff Office or Credentialing Office in a hospital, health plan or Credentials Verification Organization (CVO) environment.
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20% Communicates (both verbally and in written form) with providers, provider relations, marketing, other credentialing departments, and various management staff relating to any urgent matters.
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provider credentialing verification jobs
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