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Wellstar Health System

Credentialing Specialist WMCG- Augusta Georgia

Posted an hour ago
2-5 years experience
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AI Summary

The Credentialing Specialist manages the credentialing, reappointment, and termination processes for medical staff to ensure accurate and confidential file maintenance. They also support medical staff office operations, including database management, report generation, and ensuring compliance with bylaws and regulations.

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Various (United States of America)

Job Summary:

The Credentialing Specialist assists in the planning, developing, organizing and processing the operations for the credentialing appointments/reappointments and terminations of the Medical Staff Office in order to contribute to meeting the mission and goals of the Department and Hospital. This role ensures all credential/quality files are created and maintained accurately and confidentially.

Core Responsibilities and Essential Functions:

  • Updates/maintains MD Staff database. Runs monthly reports. Ensures all credential/quality files are created and maintained accurately and confidentially. Updates/maintains privilege forms/forms in database. Completes online verifications on initial and reappointments.
  • Completes and meets deadlines for credentialing process including creating appointment/reappointment letters. Mails letters with a copy of privileges to the practitioners, ensuring copy of letters and privileges are in the Credentials files. Creates credential files for new appointments. Files reappointment information for files that have been processed through the Credentials Committee, turn and enter practitioners’ information in the database after Board approval.
  • Assist the Supervisors Medical Staff Office, Chief Medical Officer, Director CMO Business Operations and Administrative Assistant to the CMO, as necessary. Assists Supervisors Medical Staff Office with Annual Medical Staff Meeting. Assists with delegated annual reviews by managed care companies. Manages office expenditures including all office/supply orders for the department and the supply budget in adherence with rules and regulations.
  • Assists physicians and other credentialed health care professionals to adhere to and interpret the Medical Staff Bylaws, Rules and Regulations, and Credentialing Policy. 

Required Minimum Education:

Highschool diploma or GED

Required Minimum Experience:

2 years or more of experience in credentialing/privileging providers, or provider enrollment, or revenue cycle in a healthcare setting.

Required Minimum Skills:

Microsoft Word, Excel and PowerPoint

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.

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