POSITION SUMMARY

The Medical Staff Services Specialist is responsible for internal credentialing and privileging, as well as payer enrollment new provider enrollment.  This position ensures current providers maintain credentialing and active eligibility to provide services and ensure that applicable standards and regulations are monitored. Can perform all duties of Associate Medical Staff Services Specialist role.

OUR CORE VALUES

• Inclusion
• Nurture
• Service
• Purposeful
• Integrity
• Resilient
• Engaged

EXPECTATIONS

Every Adelante Healthcare employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day.  Employees are expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism, and competence.

ESSENTIAL SKILLS AND EXPERIENCE:

• High School diploma or GED from an accredited institution, four (4) year college degree preferred
• Two (2) plus years credentialing experience required
• Professional and effective oral and written communication skills
• Organizational skills; ability to multi-task and manage priorities; meet critical deadlines
• Proficient in Microsoft Excel, Outlook and Word and proprietary database applications
• Attention to detail, objectivity and accurate documentation skills
• Excellent customer service orientation with the ability to communicate professionally both verbally and in writing with providers, payers, staff and leadership
• Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations

POSITION REPONSIBILITIES

• Create, facilitate, and track completion of clinician applications for payers to ensure timely credentialing and enrollment.
• Process credentialing and re-credentialing applications of clinical staff
• Maintain database with up to date provider information
• Acts as primary contact for internal and external customers for administrative matters associated with credentialing
• Back-up coverage of duties performed by Associate Medical Staff Services Specialist
• Assist in onboarding new providers
• Create/follow monthly reports for expirables/audits
• Works with National Health Service Core to process verifications
• Work with hospital partners on privileging for providers

NONESSENTIAL SKILLS AND EXPERIENCE:

• Three (3) years of experience in community health
• Knowledge of medical terminology