SOMA - Credentialing Specialist

Employer
A.T. Still University
Location
Arizona, United States
Salary
Salary Not Specified
Posted
May 25, 2021
Employment Type
Full Time


A.T. Still University's School of Osteopathic Medicine in Arizona (ATSU-SOMA) invites applications for a Credentialing Specialist on the Mesa, Arizona campus, who ensures SOMA medical faculty and preceptor members maintain current credentials and licenses to work legally in their field or specialty. The specialist monitors upcoming renewal dates and works with medical staff to advise them of the required steps to maintain their credentials. They review information on potential new employees to make sure all required licenses and credentials are current before hiring. They manage the electronic database for the data in confidentially and securely in accordance with federal, state and local regulations. In addition, they will be responsible for running reports and analysis as requested.

Major Job Duties:
  • Efficiently performs Primary Source credentialing verification for SOMA faculty and all providers that educate ATSU medical students by collecting board certifications or residency completion verification (for board eligibility), state licensure, malpractice insurance, and CV. As well as completing and submitting individual and group applications for new faculty and preceptors for ATSU-SOMA new Community Heath Care (CHC) partner locations and re-credentialing applications.
  • Prepares reports for the Dean's review and approval for preceptors with a board action.
  • Responsible for gathering and verifying highly confidential and sensitive provider credentials consistent with The Commission of Osteopathic College Accreditation (COCA) standards.
  • Collects and verifies Federal Tort Claims Act (FTCA) malpractice coverage verification annually for each ATSU-SOMA CHC partner site.
  • Processes appropriate queries for expired licensure, or any appropriate regulatory credentialing requirement and maintains documentation in the database.
  • Ensures that all credentialing files are current and complete pursuant to expiration date of medical licenses, board certification, professional liability insurance coverage, and other pertinent information per COCA standards.
  • Notifies and assists preceptors in renewing expired credentials such as licensure, board certifications, and malpractice insurance as required by COCA standards while ensuring that all credentials are always current.
  • Monitors collection of all information received; follows up on missing items and/or incomplete forms, submits follow up requests for verifications as needed.
  • Identifies and monitors preceptor sanctions on licensure.
  • Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow up. This process often requires a meticulous timely and conscientious effort to ensure resolution.
  • Advises Assistant Dean of questionable information received, and any issues identified during the processes.
  • Creates and manages provider back up files in the Google Drive.
  • Maintains appropriate communication with Assistant Dean, Operations Director, and other colleagues as needed to complete credentialing process for all student rotations and SOMA faculty.
  • Maintains appropriate communication with Associate Dean to review and analyze applications for initial credentialing and recredentialing, assessing completeness of information and qualifications to established standards.
  • Maintains appropriate communication with colleagues regarding any issues with credentialing for student rotations.
  • Looks over student rotation grids daily to find providers that need to be credentialed. Includes detailed documentation on grids and in eValue for due diligence requirement.
  • Communicates with Federation of State Medical Boards, American Board of Medical Specialties, and the American Osteopathic Association with any discrepancies.
  • Manages SOMA Credentialing email.
  • Manages AOA Board Profile Check Register to keep track of balance on AOA Physician Profile account.
  • Provides email communication with providers for completion of adjunct clinical faculty applications and/or requests for missing or updated credentialing documents.
  • Responsible for completing reports to find “CORE” preceptors used 3 or more times to send adjunct clinical faculty applications on a quarterly basis.
  • Responsible for completing reports to find expired adjunct clinical faculty rankings and send renewal letters.
  • Responsible for completing data reports for various basic configurations of data such as provider profiles, pending provider lists, and expired credentials.
  • Responsible for completing all preceptor work verifications.
  • Obtains and supplies information to correctly all bill services.
  • Updates Primary Source Application on an ongoing basis as required.
  • Assists Director of Operations with credentialing of new faculty members and entering information into database.
  • Documents in detail into all digital platforms needed when any exceptions to processes occur for specific preceptor situations as they arise.
Skills/Requirements:
  • 2 year college certificate or equivalent required.
  • 3 years credentialing experience with CPCS (Certified Provider Credentialing Specialist) certification required.
  • Must have experience with Microsoft Office Suite, innovative data management platforms.
  • Prior credentialing experience and knowledge of credentialing procedures, to include time lines for credentialing.
  • Strong verbal and written communication skills.
  • Strong detail-oriented organizational skills.
  • Skill in identifying and resolving problems.
  • Skill in creating, revising, and implementing verbal and written instructions.
  • Skill in establishing and maintaining effective working relationships with administration, management, faculty, staff, and providers.

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