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Privileging Specialist Full-time Job

5 months ago Sales & Services Pittsburgh   133 views
Job Details

Job Description :

GENERAL OVERVIEW:

Coordinates the privileging processes for appointment and reappointment of both physicians and allied health professionals with requirements of the Medical Staff Bylaws and all federal/state regulatory and/or accrediting agencies.


ESSENTIAL RESPONSIBILITIES:

  • Coordinates and implements the privileging process for the Medical Staff and Allied Health Professional Staff for initial appointments, focused professional practice evaluations, reappointments, changes in status or privileges and temporary privileges.
  • Maintains and utilizes a comprehensive computer database for the privileging function including providing data reports as required or requested.
  • Maintains credential files for the Medical Staff and Allied Health Professional Staff according to the Medical Staff Bylaws and all federal/state regulatory and/or accrediting agencies.
  • Facilitates organization and development of monthly Credentials Committee and Allied Health Professional Subcommittee agendas in order to comply with Managed Care requirements.
  • Performs other duties as assigned or required.

QUALIFICATIONS:

Minimum

  • High School diploma or GED
  • 3 years’ experience in office administration in a medical environment
  • Strong interpersonal, organizational, and problem-solving skills
  • Demonstrated proficiency in PC applications including Microsoft Office

Preferred

  • Associate's Degree
  • Certified Provider Credentialing Specialist (CCPCS) by the National Association of Medical Staff Services.
  • Strong knowledge of medical terminology
  • Minimum 2 years’ experience in medical staff credentialing
  • Working knowledge of medical staff functions including credentialing and governance

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

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Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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Company Description
Our mission is to create a remarkable health experience, freeing people to be their best.
At Allegheny Health Network, our employees make a significant impact on people’s lives every day. They are a proud and passionate team who work together to provide the highest quality patient care – care that helps people live longer, healthier lives.