Credentialing Specialist
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Job Description
Credentialing Specialist supporting Intermountain Health’s centralized provider verification program. Processing credentialing applications and maintaining compliant medical staff records remotely.
Responsibilities:
- Facilitate Intermountain Health’s centralized verification office (CVO) program
- Serve as the primary credentialing liaison for hospitals, providers, and network participating providers
- Facilitate all aspects of the Primary Source Verification program
- Verify applicants’ education, training, and experience directly with primary sources
- Review and ensure provider information accuracy in credentialing software
- Process initial credentialing and re-credentialing applications
- Capture primary-source documentation in computer databases
- Prepare and maintain reports of credentialing activities, including accreditation, membership, and facility privileges
- Ensure applications comply with applicable laws, regulations, procedures, and policies
- Maintain current credentialing guidelines and keep records and applications ready for Hospital Medical Staff Office and Medical Staff Committee review
- Maintain frequent contact with medical staff services professionals, administrators, and practitioners
- Keep CVO leaders informed of problems or concerns
- Incorporate accreditation and regulatory standards into medical staff activities
- Maintain provider records, including expirable items and other required documents
- Work Monday–Friday during business hours with no holidays, weekends, or nights
Requirements:
- Effective verbal and written communication skills and ability to work well with a team
- Intermediate-level experience with Word, Excel, Adobe, and OneNote
- Comfort learning a sophisticated database program
- Ability to work with a variety of healthcare professionals
- Ability to function with minimal supervision and remain self-motivated
- Ability to keep confidences and adapt to frequent interruptions
- Problem-solving and decision-making ability
- Organization and good communication skills
- Working knowledge of TJC and NCQA standards, and state and federal guidelines and requirements
- High school graduation or equivalent required
- Knowledge of medical terminology required
- Bachelor's Degree from an accredited institution preferred
- CPCS or CPMSM certification preferred; certification required within five years of employment
- Minimum of one year of administrative work experience
- Experience as a medical staff coordinator, medical staff credentials specialist, or privileging coordinator
- One year of experience in a healthcare, legal, or insurance environment
- Ability to see/read information and communicate with providers, colleagues, customers, patients/clients, and visitors
- Manual dexterity for computer use and handling supplies/equipment
Benefits:
- Generous benefits package covering programs supporting wellness, health, security, connection, and engagement
- Remote work expectations include use of company equipment
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