Responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process across the Pinnacle Treatment Centers continuum (providers and facilities). Facilitates all aspects of credentialing, including initial appointment and reappointment. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. Works under the supervision of the Director of Revenue Cycle.
• Performs miscellaneous job-related duties as assigned
• Leads, coordinates, and monitors the review and analysis of provider and facility applications and accompanying documents, ensuring applicant eligibility
• Maintain compliance with all regulatory and accrediting institutions
• Monitor staff credentials and licenses
• Participate in the development of internal credentialing processes
• Keep records in licenses, credentials and insurance contracts
• Release information to agencies and members of the public as required by law
Knowledge, Skills and Abilities Required
• Ability to communicate effectively, both orally and in writing.
• Program planning and implementation skills.
• Knowledge of related accreditation and certification requirements.
• Knowledge of medical credentialing and privileging procedures and standards.
• Ability to analyze, interpret and draw inferences from research findings, and prepare reports.
• Informational research skills.
• Ability to use independent judgment to manage and impart confidential information.
• Ability to make administrative/procedural decisions and judgments.
• Must be skilled in Microsoft applications
• Must have excellent work habits, including a flexible schedule to work hours necessary to get the job done.
• Must have previous credentialing experience- minimum of 2 years
We are an Equal Opportunity Employer with a commitment to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability or veteran status.