Credentialing Specialist, Antelope Valley Hospital, Lancaster, CA

Posted on August 21st, 2017

Job Title:                     Credentialing Specialist - Medical Staff Services - Full Time/Days 
Job ID:                        507035
Location:                     Antelope Valley Hospital, Lancaster, CA
Full/Part Time:             Full Time
Regular/Temporary:      Regular

Antelope Valley Hospital (AVH) offers a wide variety of employment options and career advancement opportunities. With competitive salaries and generous benefits options, AVH is an employer-of-choice in the Antelope Valley.

Located just 50 miles north of Los Angeles, Antelope Valley Hospital (AVH) has served as the area's leading healthcare provider for more than 60 years. The 420-bed hospital cares for nearly 220,000 patient visits a year, 121,000 of those come through the emergency department alone. With 2,500 employees and more than 450 physicians, AVH is one of the largest employers and an economic engine in the community. It offers a full complement of healthcare services, including Level II trauma center, labor & delivery, pediatrics, NICU, mental health and all of the medical/surgical services one would expect from a full-service acute care hospital. It is the area's only accredited Chest Pain Center and STEMI Receiving Center, Advanced Primary Stroke Center and Comprehensive Community Cancer Center. 

The Antelope Valley offers affordable housing, excellent schools, extensive family-friendly activities, first-class entertainment, and many dining and shopping options. 

Job Objective:

Under the direction of the Department Director, performs a wide variety of complex duties related to the hospital credentialing and recredentialing process in accordance with the Joint Commission standards and other State and Federal regulatory agencies to ensure compliance with licensing and accrediting agency requirements.

Essential Duties and Responsibilities: 

1.    Responsible for conducting the credentialing and recredentialing process for the Hospital in accordance with The Joint Commission standards and other State and Federal Regulatory agencies 
2.    Responsible for ensuring compliance with licensing and accrediting agency requirements 
3.    Responsible for conducting all credentialing functions in collaboration with other department employees to include intake, primary source verification, documentation and tracking of applications and reapplications for Medical Staff membership and clinical privileges and applications and reapplications for allied health professionals according to national quality standards 
4.    Validates provider applications for completeness, accuracy and appropriate signatures and necessary releases prior to processing 
5.    Utilizes independent judgment in determining the completeness of information prior to processing applications/reapplications and ensures accurate input of information from applications for initial appointment or renewal applications from Medical Staff and allied health professionals into the Medical Staff Department's computer software database for processing 
6.    Maintains written and verbal correspondence with applicants and references regarding status of the applications/reapplications and provides appropriate follow up in deficient areas in the application 
7.    Provides necessary assistance in planning meetings, developing agendas, preparation of committee reports, and maintenance of credentials records 
8.    Maintains and processes written and verbal correspondence with Federal, State and local agencies, hospitals, medical review and licensing boards and liability carriers regarding insurance status and claims histories through electronic inquiries or via hard copy 
9.    Assists with the maintenance of the policy and procedure manuals as they relate to the credentialing process
10.  Assists other employees in the Department involved in the credentialing process as required. 
11.   Reviews and determines whether applications/reapplications qualify for standard or expressing processing utilizing Medical Staff approved criteria and coordinates the processing of those applications with respective department chairs, the Chair or designee of the Credentials Committee and Board subcommittee members 
12.   Acts as a representative for AVH at external meetings, committees, and special events as assigned by the Department Director 
13.   Notifies appropriate hospital personnel of new appointments/resignations from the Medical Staff and allied health staff 
14.   Maintains applicant profiles for Medical Staff members and Allied Health Professionals to enable proper review through the Medical Staff structure

Non-Essential Duties: 

  • Provides clerical support for additional Medical Staff committees when requested. 
  • Other duties as assigned

Knowledge, Skills and Abilities: 

  • Knowledge of verification sources for credentialing processing 
  • Knowledge of English usage, spelling, grammar, and punctuation 
  • Knowledge of Medical Staff credentialing requirements 
  • Knowledge of records retention requirements in relation to Medical Staff documentation 
  • Must possess a solid use of the English language, spelling, grammar and punctuation 
  • Must have knowledge of medical terminology or ability to successfully complete a course in same 
  • Knowledge of the application and reappointment processes 
  • Must possess a solid understanding of privileging principles 
  • Knowledge of regulatory requirements for credentialing and privileging 
  • Knowledge of medical staff services principles, methods and procedures

Skills

  • Strong computer skills with ability to type in the range of at least 60 words per minute 
  • MS Office skills 
  • Credentialing software skills 
  • Internet research skills 
  • Telephone etiquette skills 
  • Strong interpersonal and customer service skills

Abilities

  • Ability to independently research accreditation and regulatory publications 
  • Ability to provide a high degree of accuracy 
  • Ability to exercise independent judgment, with latitude for independent initiative based on technical expertise 
  • Ability to plan, organize and control workflow 
  • Ability to complete duties with dependability and reliability 
  • Ability to learn and expand skills 
  • Ability to communicate with tact and professionalism 
  • Ability to manage stressful situations 
  • Ability to think critically and solve problems/issues 
  • Ability to resolve conflict 
  • Ability to adapt to changes in processes

Core Competencies: All AVH employees will effectively demonstrate these behaviors: 

  • Accountability 
  • Action Oriented
  • Customer Focused
  • Compassion
  • Effective Communication
  • Teamwork
  • Ethics & Values Integrity & Trust

Education and Experience: 

  • High school diploma or equivalent required. 
  • Associate's degree preferred.

Experience 

  • 1-4 years of credentialing experience or equivalent related experience 
  • Clinical experience preferred

Required Licensure and/or Certifications: 

  • NAMSS (National Association Medical Staff Services) certification in credentialing (CPCS Certification) preferred

AVH Conduct/Compliance Expectations: 

  • Ability to adhere with AVH Leaves of Absence Policy 
  • Ability to adhere with AVH Paid Time Off (PTO) Policy 
  • Ability to adhere with AVH Recording of Hours Worked Policy 
  • Ability to adhere to the department dress code 
  • Ability to organize work and establish priorities 
  • Ability to expand on own initiative in performance of duties 
  • Skill and ability to follow the telephone etiquette/standards 
  • Conforms to AVH Standards of Excellence 
  • Ability to function effectively under pressure and meet time parameters 
  • Ability to communicate effectively while maintaining good working relationships with co-workers, managers and other hospital staff 
  • Ability to adhere to the normal standards of courtesy and conduct as defined under the rules of hospitality at AVH 
  • Ability to maintain the confidentiality of patient, hospital and department information 
  • Ability to adhere to safety rules and regulations 
  • Safely and effectively uses all equipment necessary to carry out duties 
  • Ability to interpret and function under hospital and department policies and procedures 
  • Conforms with required and appropriate Joint Commission requirements 
  • Conforms with and supports hospital quality assurance and improvement guidelines 
  • Ability to participate effectively in department and hospital staff education 
  • Display a willingness to work as a team player 
  • Ability to give and support the highest level of patient/customer satisfaction at all times 
  • Supports and adheres to the values and mission statement established by the AVH Board of Directors 
  • Ability to demonstrate knowledge and understanding of Corporate Compliance rules and regulations, complies with duty to report behavior standard, demonstrates understanding of purpose for Corporate Compliance hotline and importance of seeking guidance from a supervisor when in doubt regarding possible corporate complieance issue

Key Physical Requirements and Working Conditions: 

  • Primarily works in a climate-controlled area 
  • Sitting 80% of time on duty 
  • Tolerate repetitive arm and hand movements and viewing of video display terminal 
  • Able to lift up to 10 pounds, occasionally up to 25 lbs.

A detailed description of the physical requirements of this job is maintained in the Employee Health Department.

Looking for an opportunity to work in healthcare the way you always dreamed you could? At Antelope Valley Hospital, our employees are at the heart of what we do best – delivering high quality, patient-centered healthcare.

Antelope Valley Hospital, a 420 bed acute care facility, located just 60 miles north of Los Angeles, the Antelope Valley is one of Southern California’s fasted growing communities. We are a Level II Trauma Center and Joint Commission Primary Stroke Center Accredited. Serving the community for over 50 years, our non-profit hospital has grown to be the preeminent healthcare facility for our district’s nearly 1.2 million residents. 

An Equal Opportunity Employer.

We would like to invite you to visit our careers site to complete your application.

DIRECTIONS:

1.  Select the  link to access our careers site.  
2.  Sign In to access your account or if you are not an existing user select the Register Here/Register Now link to create one.  
3.  Review the job description and select the Apply button to begin your application.

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