Job Description
Presbyterian is seeking a highly detail-oriented Credentialing Specialist to conduct comprehensive background investigations on physicians and healthcare providers seeking affiliation with our Albuquerque and regional facilities.
Type of Opportunity: Full time
Job Exempt: No
Job is based: Presbyterian Hospital
Work Shift: Days (United States of America)
Responsibilities
Some key responsibilities include:
Analyze practitioner applications and/or requests to ensure that required documentation/information has been submitted in order to initiate the primary source verification processes.
Conducts primary source verification of applicants education, licensure, professional work history, medical malpractice history for the purpose of determining competency and eligibility to be awarded membership and/or privileges.
Prepares processed files for review by appropriate members of medical staff leadership, including identification of information that may require additional investigation.
Utilizes appropriate tracking tools for the purpose of ensuring timely completion of applications.
Collects/analyzes data from various sources to include with initial and/or reappointment applications. Such data includes but is not limited to focused professional practice evaluations, ongoing professional practice evaluations, and privileging eligibility criteria.
Requirements
High School Diploma or GED.
One (1) to three (3) years experience in hospital medical staff or managed care credentialing preferred.
Certification or eligibility for certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) is preferred.
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services
Benefits
Health insuranceDental insuranceVision insurance
Additional Information
Location Address:
1100 Central Ave SE
Albuquerque, NM 87106-4930
Compensation Pay Range:
Minimum Offer $19.25
Maximum Offer $28.61
Now Hiring: Credentialing Specialist
Phsorg · Presbyterian Hospital