Position Summary: We have an exciting opportunity to join our team as a Credentials Associate.
In this role, the successful candidate Responsible for initiating, processing, reviewing and analyzing physician/allied health applications for reappointment in accordance with established credentialing standards.
Demonstrates knowledge of the organizations Service Standards and incorporates them into the performance of duties.
Initiates, processes, reviews and analyzes physician/allied health applications for reappointment in accordance with applicable credentialing standards and established procedural guidelines.
Conducts primary source verification and validation of re-credentialing documents including board certification and eligibility, licensure, accreditation, work history, liability insurance and malpractice claims history. Assesses completeness of information and qualifications relative to credentialing standards.
Flags adverse information from application materials and escalates identified flags to management for the purpose of conducting special follow-up investigations in preparation for Credentials Committee review.
Enters data from provider applications into Cactus database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses.
Prepares, issues, electronically tracks and follows-up on appropriate verifications for efficient processing of each individual application in accordance with applicable credentialing standards and established procedural guidelines.
Obtains Physician Profiles and assembles data to include all elements required by regulatory and accrediting agencies.
Employs public relations skills and uses discretion in a wide variety of email, phone and in person contacts with internal and external sources for purposes of soliciting information essential to the credentialing process and credentials investigations.
Runs data reports for various basic configurations of data such as provider profiles, pending provider lists and expired credentials to effectively manage and monitor their reappointment applications.
Internally audits, organizes and maintains provider files in accordance with established principles of legal documentation and confidentiality.
Maintains electronic work sheet/checklist of activities initiated and responses received in accordance with applicable credentialing standards and established procedural guidelines.
Maintains tickler system for follow-up of unanswered correspondence in accordance with applicable credentialing standards and established procedural guidelines. Escalates matters of significance to management for investigation and resolution.
Notifies sponsoring department and staff member of progress toward completion of the verification process. Sends second and third notices to those who do not respond by the first request.
Organizes and prepares credential files for review by management, clinical department leadership and the Credentials Committee.
Reviews credential files, as assigned, in preparation for delegated credentialing and regulatory audits.
Maintains a high degree of discretion and trustworthiness in the handling of confidential information associated with the credentialing process.
Post Committee reviews and approvals, responsible for assuring file completeness and prompt, accurate and detailed communication regarding final on-boarding of new providers.
Performs other clerical duties and assists staff with special projects as assigned.
Minimum Qualifications: To qualify you must have a High school graduate or the equivalent. Minimum of one year credentialing experience in a healthcare setting required.
Preferred Qualifications: Medical staff office experience preferred. Medical staff credentialing certification from NAMSS (National Association of Medical Staff Services) a plus. Excellent verbal and written communication skills, including knowledge of credentialing. Excellent computer skills, scanning, including word processing and data base maintenance (Cactus Software preferred). Energetic and self- motivated with the ability to complete projects independently within established timeframes. Ability to handle multiple projects and deadlines. Ability to cope with interruptions, varying personalities, rush projects, and demanding medical staff. Able to prioritize responsibilities. Independent judgment and interpersonal relationship skills in working with the staff, Medical Staff leaders and other Departments in the NYU Hospitals Center.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
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Internal Number: 82575586
About NYU Langone Medical Center
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. Included in the 200+ locations throughout the New York area are five inpatient locations: Tisch Hospital, its flagship acute-care facility; Rusk Rehabilitation, ranked as one of the top 10 rehabilitation programs in the country; NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital with all musculoskeletal specialties ranked top 10 in the country; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children's health services; and NYU Langone Hospital—Brooklyn, a full-service teaching hospital and level 1 trauma center located in Sunset Park, Brooklyn. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history.