Credentials Specialist, Full Time, Days ,Baptist Medical Group

Job Summary

The Credentialing Specialist is responsible for managing the credentialing process for healthcare providers within the organization. This role ensures that all providers meet the necessary qualifications and compliance standards set by regulatory bodies and the organization itself.

Key Responsibilities:

• Credentialing Process: Manage the credentialing and re-credentialing process for healthcare providers, including gathering necessary documentation and verifying credentials.
• Primary Source Verification: Conduct thorough primary source verification of licenses, certifications, education, and training for all providers.
• Data Management: Maintain and update credentialing databases and ensure all records are accurate and compliant with organizational policies and regulatory requirements.
• Collaboration: Work closely with medical staff, human resources, and other departments to facilitate the onboarding of new providers and maintain current provider records.
• Policy Compliance: Ensure compliance with relevant regulations, including NCQA, JCAHO, and CMS guidelines, and assist in the development and implementation of credentialing policies.
• Auditing and Reporting: Participate in regular audits of credentialing files, prepare reports on credentialing activities, and identify areas for improvement.
• Communication: Act as a point of contact for providers regarding credentialing inquiries, ensuring clear and professional communication.
• Continuous Education: Stay updated on industry trends and regulatory changes to maintain best practices in credentialing processes.

Education Required

High School Diploma/GED

Education Preferred

Associate's Degree

Experience

• 1-2 years Credentialing Experience.
• Experience working in a hospital setting.
• Knowledge of credentialing processes and regulatory requirements.
• Strong attention to detail and organizational skills.
• Excellent communication and interpersonal skills.
• Proficiency in credentialing software and Microsoft Office Suite.

License and Certification

• Certified Professional Credentialing Specialist (CPCS) Preferred

Location

Location Overview

Baptist Health, founded in 1955, is North Florida’s most comprehensive health care system and the area’s only non-profit, mission-driven, locally governed health care provider. Baptist Health has over 200 points of care throughout the Northeast Florida region, including our six award-winning hospitals: Baptist Medical Center Jacksonville, Wolfson Children’s Hospital, Baptist Medical Center Beaches, Baptist Medical Center Clay, Baptist Medical Center Nassau and Baptist Medical Center South. The most preferred health care system in the region, Baptist Health also includes 57 primary care offices, as well as home health, behavioral health, pastoral care, rehabilitation services, occupational health and urgent care.