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Credentialing Specialist

Army National Guard, VA
Job Description:
The purpose of this position is to provide credentialing and privileging services and support to the Army National Guard .The candidate will support in transitioning   providers with initial entry credentialing, maintenance of credentialing and privileging, and support the Centralized Credentials Privileging Board’s review of completed credentials and privileging files. The candidate must be familiar with the credentialing process to insure acceptable performance. The candidate will support the credentialing process of assessing and reviewing the qualifications of the health care practitioner. The process includes review of the licensure, training and education of skilled care providers (e.g. Physicians, Dentists, Family Nurse Practitioners and Physician Assistants) and assures their clinical competency and that they maintain regulatory compliance in their scope of practice.
 
Job Responsibilities:
  • Managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health).
  • Reviewing applications for completion, verification of state licensure / training / education, and collecting information contained in the national physician data bank (NPDB).
  • Providing direct supervision to the support staff in administering all aspects of processing applications.
  • Compiling all documents and building credential review files for review by the Centralized Credentials Privileging Board and documenting results.
  • Generating and mailing notification letters of credentialing results to applicants and/or responding to questions from applicants regarding status of credentialing.
  • Entering data in the CCQAS as directed.
Qualifications:
  • Bachelor's Degree in a Healthcare, Quality Assurance, or related field
  • Three (3) years of experience, including experience with medical credentialing. An equivalent combination of education and experience may be considered in lieu of the degree.
  • Minimum 3 years credentialing experience.
  • Excellent communication and interpersonal skills.
  • Experience using MS Office, i.e. Word, Excel, and/or PowerPoint.
  • US Citizenship and ability to obtain a favorable National Agency Check with Inquiries (NACI) or Interim Secret clearance.
  • Experience in the DOD credentials process is a plus.
  • Experience with CCQAS is a plus.
 
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