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Job Title:
Delegated Credentialing Specialist
Department:
University Hospital | Credentialing Services
Scope of Position:
The Credentialing Specialist will assume total responsibility of credentialing of providers from hire to enrollment in managed care plans. The Credentialing Specialist provides services for all entities within the healthcare system.
Position Summary:
Primary responsibility will be initiating and monitoring the provider corporate credentialing functions to assure that all practitioners are credentialed in accordance with established thresholds. This would include primary source verification and medical staff privileging assuring compliance with NCQA and JCAHO standards. Also, responsibility will include enrollment into governmental payor plans (Medicare, Medicaid, Bureau of Workers Compensation, etc.) and enrollment into other non-delegated health plans. CVO Specialist may also be asked to work on special projects for providers, which might include assisting with credentialing process for other healthcare institutions when a business relationship exists. This position requires excellent verbal and written communication skills and the ability to work independently, while managing multiple priorities.
Required Qualifications:
Bachelor's degree in health related or educational field
4 years experience in a hospital setting and/or managed care setting or equivalent combination of education and experience
Strong verbal and written communication skills; Strong organizational skills and attention to detail
Ability to work with minimal supervision and to maintain confidentiality due to access to sensitive information
Ability to problem solve and think creatively
Knowledge of NCQA and JCAHO as they relate to current credentialing and re-credentialing standards
Working knowledge of Microsoft Word and Excel
CPMSM or CPCS certification preferred
Our Comprehensive Employee Benefits Include:
An array of retirement plan options, each with a generous employer contribution.
Affordable health insurance options, including dental, vision and prescription coverage that begin on day one.
Paid vacation and sick leave, including short and long-term disability and paid parental leave.
Get the most out of the Public Service Loan Forgiveness program.
And much more!
Additional Information:
Location:
Ackerman Rd, 700 (0921)
Position Type:
Regular
Scheduled Hours:
40
Shift:
First Shift
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.
The university is an equal opportunity employer, including veterans and disability.
As required by Ohio Revised Code section 3345.0216, Ohio State will: educate students by means of free, open and rigorous intellectual inquiry to seek the truth; equip students with the opportunity to develop intellectual skills to reach their own, informed conclusions; not require, favor, disfavor or prohibit speech or lawful assembly; create a community dedicated to an ethic of civil and free inquiry, which respects the autonomy of each member, supports individual capacities for growth and tolerates differences in opinion; treat all faculty, staff and students as individuals, hold them to equal standards and provide equality of opportunity with regard to race, ethnicity, religion, sex, sexual orientation, gender identity or gender expression.
Medical, Clinical & Veterinary (1)