Credentialing Specialist

The Credentialing Specialist is responsible for the administration and coordination of all credentialing and reappointment/recredentialing  activities. Ensures the needs of medical staff are met through efficient processes, assuring compliance to accreditation standards, government agencies, as well as Orlando Health bylaws, rules & regulations.

Ability to work hybrid schedule once training has been completed. 3 days onsite and 2 work from home/remote days.

Hours: Monday-Friday 8:00am-4:30pm

Essential Functions

• Performs credentialing functions as outlined by Bayfront Health management in accordance with established policy, procedures, and protocols.
• Performs timely and accurate primary source verification in addition to credentialing functions.
• Completes accurate and timely data entry of all credentialing activity into credentialing database.
• Provides exceptional customer service to physicians and physician office staff members as well as internal customers, such as members of other departments. Educates physicians and physician office staff on the credentialing process and maintains ongoing contact with these individuals throughout the process.
• Identifies trends and assists in the development of action plans for purpose of performance improvement. Evaluates processes in departmental policies & procedures and makes recommendations for changes to management. Develop and distribute reports as necessary utilizing credentialing database. Timely completion of all assigned duties.
• Maintains credentialing and reappointment/recredentialing files.
• Other duties as assigned
• Maintains reasonably regular, punctual attendance consistent with Bayfront Health policies, the ADA, FMLA and other federal, state, and local standards.
• Maintains compliance with all Bayfront Health policies and procedures.

Other Related Functions

• COMPLEXITY OF WORK: Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
• Knowledge of medical credentialing and privileging procedures and standards.
• Knowledge of accreditations/government agencies standards and Orlando Health bylaws, rules & regulations.
• Assumes responsibility for professional growth and development

Education/Training

• High school graduate or equivalent.
• Knowledge of medical terminology.

Experience

• Three (3) years minimum experience credentialing/privileging or;
• One (1) year of credentialing/privileging experience and/or two (2) years of clinical experience.
• Proficiency in Microsoft Word, Excel, Internet and significant proficiency in credentialing data system.