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Credentialing Specialist I

Roanoke, VA, US, 24011

Requisition Number: 48213 
Employment Status: Full time
Shift: Day
Shift Details: 8:00 - 4:30

 

Job Summary

Be at your best with an organization that equips you to do so.  Whose people unite in making lives better. At Carilion Clinic, we help communities stay healthy and our region grow stronger through compassionate care, medical education and research, and neighborhood outreach. As part of our team you can expect professional stability, strong technological resources, and the advancement potential of a regional leader.

 

Assists Director, Medical Staff Services and CCVS co-workers to carry out the duties of the CCVS Department; to provide initial/reappointment/update credentialing verifications for facilities/entities of Carilion Clinic and associated Health plans; and to provide support and documentation of Centralized Verification Services activities, enabling the Carilion Clinic areas facilities/entities and associated Health plans, to fulfill their duties and obligations in accordance with Bylaws/Policies/Procedures, and to meet requirements of regulatory agencies (JC, NCQA, URAC and CMS) and to comply with confidentiality policies.  Process initial credential/reappointment/update applications and perform verification of credentials in a timely and accurate manner for facilities/entities of the Carilion Clinic and associated Health plans. Responsible for accurate entry of all applicants in credentialing software system and maintaining accurate, orderly hard-copy/electronic credentials files for all individuals for whom centralized verification services is provided.  Create and/or render reports as needed.

 

Reviews credentialing verification documentation to insure that the file is complete and any required explanatory materials are included.  Tracks and updates information on all providers and performs timely follow-up for outstanding documents.  Disseminates information to appropriate Carilion Clinic facilities/entities and Health plans in accordance with established policies/procedures.

 

Based in Roanoke, VA, we are an award-winning, community-based network of hospitals, primary and specialty physician practices, and affiliations with prestigious academic medical institutions. Explore how joining a regional leader can enhance your ability to learn, grow, and succeed.

Minimum Qualifications

Education: High school diploma with training in office and computer skills. Some college education preferred.

Experience: Minimum of three (3) years office experience, preferably in Medical Staff Services, Centralized Verification Organization, and credentialing or similar activities. Licensure, certification, and/or registration: Certified Provider Credentialing Specialist (CPCS) preferred, ability to gain certification within 4 years.

Other: Very detail/results oriented. Computer proficient. Ability to problem solve. Team player. Good interpersonal, organizational, oral and written communication skills. On-job-training in JCAHO, NCQA, URAC credentialing guidelines and regulatory agency requirements.

Our Values

Below are our core values that we strive to embody and expect of all our team members:

CommUNITY:  Working in unison to serve our community, our Carilion family and our loved ones.

Courage:  Doing what’s right for our patients without question.

Commitment:  Unwavering in our quest for exceptional quality and service.

Compassion:  Putting heart into everything we do.

Curiosity:  Fostering creativity and innovation in our pursuit of excellence.

 

 


Requisition Number: 48213 
Employment Status: Full time 
Location: CASB - Carilion Administrative Services Building 
Shift: Day 
Shift Details: 8:00 - 4:30
Recruiter: DANA E JOHNSON 
Recruiter Phone: 540-983-4006 
Recruiter Email: dejohnson@carilionclinic.org


This is Carilion Clinic ...

An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning
hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.

Equal Opportunity Employer

Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity

Carilion Clinic is a drug-free workplace.